Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | E7793 | TX |
NPI | 1043265796 |
---|---|
Provider Name | Michael H Allen |
First Address | Dallas, TX 75246 |
Second Address | Dallas, TX 75246 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00BL59 | (05) | TX |
C12748 | (02) |