Provider Demographics
NPI:1053124289
Name:LEVIAS, AMBER
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:LEVIAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7110 STATE HIGHWAY 105
Mailing Address - Street 2:431
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77713-7771
Mailing Address - Country:US
Mailing Address - Phone:409-529-4877
Mailing Address - Fax:
Practice Address - Street 1:7110 STATE HIGHWAY 105
Practice Address - Street 2:431
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77713-7771
Practice Address - Country:US
Practice Address - Phone:409-529-4877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29402528172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver