Leavitt, Wayne L.

Leavitt, Wayne L. is an sole proprietor health care provider with primary practice located at 211 S Stemmons Fwy Ste F , Lewisville TX 75067-4563. He recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Technician, Other, which is considered as his primary health care specialty. Leavitt, Wayne L. can be contacted via phone (214) 668-1256.

Contact Information

Primary practice address
211 S Stemmons Fwy Ste F Lewisville TX 75067-4563
Fax: (972) 221-0099
Website:

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Technician, Other 247200000X 01-69252-01 Texas

Profile Details

NPI number 1639448350
LBN Legal business name Leavitt, Wayne L.
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 27th, 2011
Last updated Apr 10th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1639448350 NPPES
Texas MEDICAID 01-6925201

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