Provider Demographics
NPI:1033145024
Name:ALLEN, DEIDRA DESHUN (MD)
Entity Type:Individual
Prefix:
First Name:DEIDRA
Middle Name:DESHUN
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DEIDRA
Other - Middle Name:DESHUN
Other - Last Name:CURL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5907 KATY ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-1053
Mailing Address - Country:US
Mailing Address - Phone:713-303-8695
Mailing Address - Fax:
Practice Address - Street 1:5907 KATY ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-1053
Practice Address - Country:US
Practice Address - Phone:713-868-2608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1464207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I61996Medicare UPIN
TX8G8073Medicare PIN