Provider Demographics
NPI:1427436849
Name:LEYVA, RICARDO (FNP-BC)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:
Last Name:LEYVA
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 HERITAGE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-3288
Mailing Address - Country:US
Mailing Address - Phone:469-275-7597
Mailing Address - Fax:855-355-4061
Practice Address - Street 1:1575 HERITAGE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-3288
Practice Address - Country:US
Practice Address - Phone:469-275-7597
Practice Address - Fax:855-355-4061
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-18
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127970363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily