MEDICARE: DR. JUNKO LEVITT

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	235Z00000X	Speech-Language Pathologist	106530	TX

General Provider Information

NPI Number	:	1619427473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUNKO LEVITT

Provider Business Mailing Address
First Line	:	6038 SHETLAND DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-1850
Country	:	US
Telephone Number	:	214-674-1585
Fax Number	:

Provider Business Practice Location Address
First Line	:	6038 SHETLAND DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-1850
Country	:	US
Telephone Number	:	214-674-1585
Fax Number	:

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

Provider Enumeration Date	:	10/05/2016
Last Update Date	:	10/05/2016

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Directions to “ DR. JUNKO LEVITT ” Practice Location

Language	Start Address	Practice Location

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