1740674043 NPI number — DR. EMILY ILA LEVY KAMUGISHA M.D., AAHIVS

Table of content: DR. EMILY ILA LEVY KAMUGISHA M.D., AAHIVS (NPI 1740674043)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740674043 NPI number — DR. EMILY ILA LEVY KAMUGISHA M.D., AAHIVS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEVY KAMUGISHA
Provider First Name:
EMILY
Provider Middle Name:
ILA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D., AAHIVS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LEVY
Provider Other First Name:
EMILY
Provider Other Middle Name:
ILA
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1740674043
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/25/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8194 WALNUT HILL LANE, PROFESSIONAL OFFICE BUILDING 5
Provider Second Line Business Mailing Address:
STE 100
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75231-4316
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-891-6400
Provider Business Mailing Address Fax Number:
214-891-6401

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8194 WALNUT HILL LANE, PROFESSIONAL OFFICE BUILDING 5
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75231-4316
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-891-6400
Provider Business Practice Location Address Fax Number:
214-891-6401
Provider Enumeration Date:
03/24/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  Q9849 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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