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General NPI Number Information
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NPI Number | 1164240784
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Entity Type | Organization
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Legal Business Name | LEVY ENTERPRISE LLC
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 440 LOUISIANA ST STE 900
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City | HOUSTON
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State | TX
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Zip | 77002-1062
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Country | US
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Telephone | 866-577-2267
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Fax | 713-250-8667
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Provider Business Mailing Address
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Address Line | 1807 EWING ST APT 10A
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City | HOUSTON
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State | TX
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Zip | 77004-7334
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Country | US
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Telephone | 404-647-3038
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Fax |
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Authorized Official
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Title or Position | CRANIAL PROSTHESIS SPECIALIST
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Name | MS. A'RAVEN GRIFFIN
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Credential | SPECIALIST
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Telephone | 404-647-3038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1744P3200X
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Taxonomy Name | Prosthetics Case Management
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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