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Individual

LAUREN M. LEVITON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 531-4522
Mailing address
PO BOX 841656, DALLAS, TX 75284-1656
(903) 531-5000

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP124704
TX
367500000X
Certified Registered Nurse Anesthetist
R868392
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
332523502
TX
01
75-0818167-015
TRICARE
TX
01
8839UH
BCBS
TX
01
P01380866
RAILROAD MEDICARE
TX
Enumeration date
07/05/2008
Last updated
03/05/2015
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