Provider Demographics
NPI:1265077838
Name:LEVANO, MARIA (PA)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:LEVANO
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 1:221 W. COLORADO BLVD.
Mailing Address - Street 2:PAVILION II SUITE 933
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208
Mailing Address - Country:US
Mailing Address - Phone:214-947-3684
Mailing Address - Fax:214-947-3686
Practice Address - Street 1:221 W. COLORADO BLVD.
Practice Address - Street 2:PAVILION II SUITE 933
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208
Practice Address - Country:US
Practice Address - Phone:214-947-3684
Practice Address - Fax:214-947-3686
Is Sole Proprietor?:No
Enumeration Date:2019-11-07
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY363A00000X
TXPA13275363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant