Leavens, Thomas A.
Leavens, Thomas A. is an individual health care provider with primary practice located at 1307 8Th Ave #408, Fort Worth TX 76104-4137. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Leavens, Thomas A. can be contacted via phone (817) 921-4191.Contact Information
Primary practice address
1307 8Th Ave #408
Fort Worth TX 76104-4137
Phone: (817) 921-4191
Fax: (817) 924-3096
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | J3335 | Texas |
Profile Details
NPI number | 1114910460 |
---|---|
LBN Legal business name | Leavens, Thomas A. |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 23rd, 2005 |
Last updated | May 7th, 2014 - about 10 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1114910460 | NPPES |
Texas | MEDICAID | PO84930F9 |
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