Provider Demographics
NPI:1285329516
Name:LEVEL ONE EMERGENCY ANNA LLC
Entity type:Organization
Organization Name:LEVEL ONE EMERGENCY ANNA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:M
Authorized Official - Last Name:KEELEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:214-433-9602
Mailing Address - Street 1:5900 BALCONES DR STE 16327
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4257
Mailing Address - Country:US
Mailing Address - Phone:214-433-9602
Mailing Address - Fax:
Practice Address - Street 1:2710 W HACKBERRY LN
Practice Address - Street 2:
Practice Address - City:ANNA
Practice Address - State:TX
Practice Address - Zip Code:75409-2573
Practice Address - Country:US
Practice Address - Phone:214-831-2600
Practice Address - Fax:214-831-2629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-11
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty