Individual
MR. WAYNE L. LEAVITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
211 S STEMMONS FWY STE F, LEWISVILLE, TX 75067-4563
(214) 668-1256
(972) 221-0099
Mailing address
211 S STEMMONS FWY STE F, LEWISVILLE, TX 75067-4563
(214) 668-1256
(972) 221-0099
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
01-69252-01
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01-6925201
—
TX
Enumeration date
12/27/2011
Last updated
04/10/2015
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