Provider Demographics
NPI:1316164783
Name:LEVERTON, ROBERT S II (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:S
Last Name:LEVERTON
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5709
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79608-5709
Mailing Address - Country:US
Mailing Address - Phone:325-691-5895
Mailing Address - Fax:325-691-9595
Practice Address - Street 1:6200 REGIONAL PLZ
Practice Address - Street 2:STE 1250
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5258
Practice Address - Country:US
Practice Address - Phone:325-691-5895
Practice Address - Fax:325-691-9595
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF5274207R00000X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX752069647OtherCHAMPUS AND CHAMPVA
TX089633403Medicaid
TX752069647OtherALL TRICARE PLANS
TX752069647OtherMOST COMMERCIAL INS PLANS
8AJ153OtherBCBS
TX752069647OtherCHAMPUS AND CHAMPVA
TX089633403Medicaid
8F6997Medicare PIN