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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114910460 NPPES
Texas MEDICAID PO84930F9

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