Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 23885 | WV |
Y | 207PE0004X | Emergency Medical Services | P5862 | TX |
NPI | 1083656433 |
---|---|
Provider Name | Dr. Allan Dean Packer |
First Address | Frisco, TX 75035-5221 |
Second Address | Frisco, TX 75035 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2006 |
Last Update Date | 08/08/2018 |