MEDICARE: TRINITY LEVINE

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	103K00000X	Behavior Analyst	1-24-76775	TX

General Provider Information

NPI Number	:	1043976962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRINITY LEVINE

Provider Business Mailing Address
First Line	:	1600 CENTRAL DR STE 160
Second Line	:
City	:	BEDFORD
State	:	TX
Zip	:	76022-6029
Country	:	US
Telephone Number	:	469-788-8288
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 CENTRAL DR STE 160
Second Line	:
City	:	BEDFORD
State	:	TX
Zip	:	76022-6029
Country	:	US
Telephone Number	:	469-788-8288
Fax Number	:

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

Provider Enumeration Date	:	11/15/2021
Last Update Date	:	12/27/2024

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Directions to “ TRINITY LEVINE ” Practice Location

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