Provider Demographics
NPI:1447237235
Name:ALLEN, RORY LAMAR (DO)
Entity Type:Individual
Prefix:
First Name:RORY
Middle Name:LAMAR
Last Name:ALLEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 612865
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75261-2865
Mailing Address - Country:US
Mailing Address - Phone:940-231-4577
Mailing Address - Fax:
Practice Address - Street 1:2900 N INTERSTATE 35 STE 110
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-5142
Practice Address - Country:US
Practice Address - Phone:940-536-0616
Practice Address - Fax:940-536-0619
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7643207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K5925Medicare UPIN