Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 1533 | TX |
NPI | 1013957232 |
---|---|
Provider Name | Dr. David Matthew Allen |
First Address | Athens, TX 75751-3646 |
Second Address | Athens, TX 75751-3646 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 14/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0067GR | BCBS PROVIDER NUMBER (01) | TX |
1427226711 | DME NPI (01) | TX |
146346501 | (05) | TX |
7119262 | AETNA PROVIDER NUMBER (01) | TX |
8285178 | BLUE LINK # (01) | TX |
U85178 | (02) | TX |