Basic Information
| Provider Information | |||||||||
| NPI: | 1023281151 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SVOR | ||||||||
| FirstName: | LEAH | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3093 WHISPERING OAKS DR | ||||||||
| Address2: | |||||||||
| City: | HIGHLAND VILLAGE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750771854 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2149570020 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5910 N MACARTHUR BLVD | ||||||||
| Address2: | STE 133 | ||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750393835 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9725548494 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2008 | ||||||||
| LastUpdateDate: | 12/09/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA05584 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | 281662102 | 05 | TX | MEDICAID | 281662101 | 05 | TX | MEDICAID |