1265469357 NPI number — ALLEN ANESTHESIA ASSOCIATES

Table of content: (NPI 1265469357)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265469357 NPI number — ALLEN ANESTHESIA ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLEN ANESTHESIA ASSOCIATES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265469357
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
906 W MCDERMOTT DR
Provider Second Line Business Mailing Address:
SUITE 116-371
Provider Business Mailing Address City Name:
ALLEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75013-6510
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-541-1600
Provider Business Mailing Address Fax Number:
469-541-1612

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4510 MEDICAL CENTER DR STE 211
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MCKINNEY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75069-1602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
469-541-1600
Provider Business Practice Location Address Fax Number:
469-541-1612
Provider Enumeration Date:
06/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BERG
Authorized Official First Name:
ALISHA
Authorized Official Middle Name:
R
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
469-541-1600

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 157825402 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com