Provider Demographics
NPI:1023281151
Name:SVOR, LEAH MARIE (PA)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:MARIE
Last Name:SVOR
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3093 WHISPERING OAKS DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-1854
Mailing Address - Country:US
Mailing Address - Phone:214-957-0020
Mailing Address - Fax:
Practice Address - Street 1:5910 N MACARTHUR BLVD
Practice Address - Street 2:STE 133
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-3835
Practice Address - Country:US
Practice Address - Phone:972-554-8494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05584363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX281662102Medicaid
TX281662101Medicaid
TX281662102Medicaid