Organization
JLYLE MEDICAL CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHIRLEY LEVENSON (OWNER)
(512) 774-0288
Entity
Organization
Contact information
Practice address
501 N STONE ST, CALDWELL, TX 77836-1134
(979) 567-8500
(979) 567-8500
Mailing address
501 N STONE ST, CALDWELL, TX 77836-1134
(979) 567-8500
(979) 567-8500
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159748601
—
TX
Enumeration date
04/05/2019
Last updated
02/21/2023
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