MEDICARE: DR. ELIZABETH LEVY PH.D.

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	103TC0700X	Clinical Psychologist	30923	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982609400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH LEVY PH.D.

Provider Business Mailing Address
First Line	:	9701 BRODIE LN
Second Line	:	STE 205
City	:	AUSTIN
State	:	TX
Zip	:	78748-6282
Country	:	US
Telephone Number	:	512-420-8444
Fax Number	:	512-233-2961

Provider Business Practice Location Address
First Line	:	9701 BRODIE LN
Second Line	:	STE 205
City	:	AUSTIN
State	:	TX
Zip	:	78748-6282
Country	:	US
Telephone Number	:	512-420-8444
Fax Number	:	512-233-2961

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

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	10/29/2021

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