Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | M4467 | TX |
Y | 207ND0900X | Dermatopathologist | M4467 | TX |
NPI | 1033256821 |
---|---|
Provider Name | Dr. Allison Beckworth Readinger |
First Address | Fort Worth, TX 76104-2602 |
Second Address | Fort Worth, TX 76104-2602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2007 |
Last Update Date | 10/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8J3741 | BLUE CROSS BLUE SHIELD OF TEXAS (01) | TX |