1962585109 NPI number — DR. ALLEN JEFFREY SOL OD

Table of content: DR. ALLEN JEFFREY SOL OD (NPI 1962585109)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962585109 NPI number — DR. ALLEN JEFFREY SOL OD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOL
Provider First Name:
ALLEN
Provider Middle Name:
JEFFREY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
OD
Provider Gender Code:
M

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:
1962585109
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/16/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 N US HIGHWAY 75
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENISON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75020-1526
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-463-6000
Provider Business Mailing Address Fax Number:
903-463-6009

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
401 N US HIGHWAY 75
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENISON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75020-1526
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-463-6000
Provider Business Practice Location Address Fax Number:
903-463-6009
Provider Enumeration Date:
10/23/2006

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: 152W00000X , with the licence number:  3111 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: 7364T , 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)

  • Identifier: 153318 . This is a "HARVARD PILGRIM HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 22-00492 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0031123 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0313599 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 257457 . This is a "BLUE CROSS RI" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 59623 . This is a "FALLON HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: W15826 . This is a "BLUE CROSS MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 11713 . This is a "SPECTERA VISON PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 405458 . This is a "BLUE CHIP RI" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 93727 . This is a "AETNA/US HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: BZ 09211701 . This is a "CIGNA HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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