Basic Information
| Provider Information | |||||||||
| NPI: | 1568554707 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEVINGSTON | ||||||||
| FirstName: | YVETTE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 846098 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752846098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9033246450 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5321 S FM 14 | ||||||||
| Address2: | |||||||||
| City: | HAWKINS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 757654839 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9037692990 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2006 | ||||||||
| LastUpdateDate: | 07/01/2019 | ||||||||
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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 | 363L00000X | AP112037 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 8108NN | 01 | TX | BCBS | OTHER | 157066506 | 05 | TX | MEDICAID | 75-2616977-066 | 01 | TX | TRICARE | OTHER | 787736 | 01 | TX | MEDICARE | OTHER | P01447595 | 01 | TX | RAIL ROAD MEDICARE | OTHER | P02223393 | 01 | TX | MEDICARE RAIL ROAD | OTHER |