MEDICARE: DR. ANDRE YUAN LEVESQUE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	P8152	TX
2	208200000X	Plastic Surgery Physician	MD.31528	AL

General Provider Information

NPI Number	:	1467611566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDRE YUAN LEVESQUE M.D.

Provider Business Mailing Address
First Line	:	11851 JOLLYVILLE RD STE 203
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-2350
Country	:	US
Telephone Number	:	512-487-5975
Fax Number	:	737-931-1976

Provider Business Practice Location Address
First Line	:	11851 JOLLYVILLE RD STE 203
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-2350
Country	:	US
Telephone Number	:	512-487-5975
Fax Number	:	737-931-1976

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2008
Last Update Date	:	03/29/2023

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