Provider Demographics
NPI:1568940492
Name:LEVIANT LLC
Entity type:Organization
Organization Name:LEVIANT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SEUN
Authorized Official - Middle Name:RAPHEAL
Authorized Official - Last Name:OLUWO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:281-829-6497
Mailing Address - Street 1:PO BOX 1197
Mailing Address - Street 2:
Mailing Address - City:BRENHAM
Mailing Address - State:TX
Mailing Address - Zip Code:77834-1197
Mailing Address - Country:US
Mailing Address - Phone:281-829-6497
Mailing Address - Fax:281-829-5381
Practice Address - Street 1:21700 KINGSLAND BLVD STE 105
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2546
Practice Address - Country:US
Practice Address - Phone:281-829-6497
Practice Address - Fax:281-829-3581
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEVIANT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-02
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX35610OtherOTHER (NON-MEDICARE) TEXAS STATE BOARD OF PHARMACY