Healthcare Provider Details

I. General information

NPI: 1528790193
Provider Name (Legal Business Name): LEVEL ONE EMERGENCY PHYSICIANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2022
Last Update Date: 02/02/2024
Certification Date: 02/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5016 S US HIGHWAY 75
DENISON TX
75020-4584
US

IV. Provider business mailing address

5900 BALCONES DR STE 16327
AUSTIN TX
78731-4257
US

V. Phone/Fax

Practice location:
  • Phone: 903-416-4000
  • Fax: 903-416-4419
Mailing address:
  • Phone: 214-433-9602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: GREGORY M KEELEN
Title or Position: CEO
Credential: DO
Phone: 214-433-9602