Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | L4851 | TX |
NPI | 1003868332 |
---|---|
Provider Name | Jennifer Elliott Allen |
First Address | Frisco, TX 75035-5513 |
Second Address | Frisco, TX 75035-5513 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 20/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H83727 | (02) | |
H83727 | (02) | TX |