Provider Demographics
NPI:1467663393
Name:CHO, ALLIS HYUN (MD)
Entity Type:Individual
Prefix:MS
First Name:ALLIS
Middle Name:HYUN
Last Name:CHO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 NORTH WALDROP DRIVE
Mailing Address - Street 2:SUITE 807
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-4715
Mailing Address - Country:US
Mailing Address - Phone:817-261-3000
Mailing Address - Fax:817-274-4292
Practice Address - Street 1:1001 NORTH WALDROP DRIVE
Practice Address - Street 2:SUITE 807
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-4715
Practice Address - Country:US
Practice Address - Phone:817-261-3000
Practice Address - Fax:817-274-4292
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXN9685174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA07911Medicaid