Provider Demographics
NPI:1225792203
Name:ALLANANDO CAMINOS
Entity Type:Organization
Organization Name:ALLANANDO CAMINOS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:HERRERA
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCDC
Authorized Official - Phone:214-463-4408
Mailing Address - Street 1:105 N MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-7413
Mailing Address - Country:US
Mailing Address - Phone:214-463-4408
Mailing Address - Fax:
Practice Address - Street 1:2144 N BELT LINE RD STE E
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-5860
Practice Address - Country:US
Practice Address - Phone:214-463-4408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3437428Medicaid