Provider Demographics
NPI:1588746309
Name:ROBERT S. LEVERTON, M.D., P.A.
Entity type:Organization
Organization Name:ROBERT S. LEVERTON, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEVERTON
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:325-691-5895
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 PLAZA
Practice Address - Street 2:SUITE 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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF5274207R00000X, 207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0035PYOtherBCBS
TX194244301Medicaid
00Y530Medicare PIN
TX0035PYOtherBCBS