Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | S3623 | TX |
N | 111NI0900X | Internist | S3623 | TX |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | S3623 | TX |
N | 207RC0000X | Internist - Cardiovascular Disease | S3623 | TX |
NPI | 1083775811 |
---|---|
Provider Name | Dr. Allen S Anderson |
First Address | San Antonio, TX 78229-3931 |
Second Address | San Antonio, TX 78229-3931 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 24/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036088621 | (05) | IL |
404553601 | (05) | TX |
404553602 | (05) | TX |
G4311 | (02) |