Healthcare Provider Details

I. General information

NPI: 1477086148
Provider Name (Legal Business Name): ANDERS JORDAN LEVERTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2017
Last Update Date: 09/27/2025
Certification Date: 09/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 S SONCY RD STE 1500
AMARILLO TX
79119-6440
US

IV. Provider business mailing address

3501 S SONCY RD STE 102
AMARILLO TX
79119-6405
US

V. Phone/Fax

Practice location:
  • Phone: 806-353-7900
  • Fax:
Mailing address:
  • Phone: 806-353-7900
  • Fax: 806-353-8321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberS3415
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: