Provider Demographics
NPI:1265469357
Name:ALLEN ANESTHESIA ASSOCIATES
Entity Type:Organization
Organization Name:ALLEN ANESTHESIA ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALISHA
Authorized Official - Middle Name:R
Authorized Official - Last Name:BERG
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:469-541-1600
Mailing Address - Street 1:906 W MCDERMOTT DR
Mailing Address - Street 2:SUITE 116-371
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-6510
Mailing Address - Country:US
Mailing Address - Phone:469-541-1600
Mailing Address - Fax:469-541-1612
Practice Address - Street 1:4510 MEDICAL CENTER DR STE 211
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1602
Practice Address - Country:US
Practice Address - Phone:469-541-1600
Practice Address - Fax:469-541-1612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX157825402Medicaid
TX00651TMedicare ID - Type Unspecified
TXTXB143001Medicare PIN
TX157825401Medicaid