Individual
PHILLIP LEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
302 UNIVERSITY BLVD, ROUND ROCK, TX 78665-1032
(512) 509-0200
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Q4449
TX
207RG0100X
Gastroenterology Physician
Primary
Q4449
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP10044287
SCOTT AND WHITE
TX
Enumeration date
04/27/2012
Last updated
12/17/2018
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