Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 6629 | TX |
NPI | 1821213349 |
---|---|
Provider Name | Dr. Julia Allen |
First Address | Georgetown, TX 78628-2733 |
Second Address | Georgetown, TX 78628-2733 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8R8120 | BCBS (01) | TX |
U60513 | (02) | TX |