Provider Demographics
NPI:1518954841
Name:ALLEN, ANNA J (DC)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:J
Last Name:ALLEN
Suffix:
Gender:F
Credentials:DC
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 451509
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75045-1509
Mailing Address - Country:US
Mailing Address - Phone:469-366-5940
Mailing Address - Fax:877-724-3362
Practice Address - Street 1:8838 VISCOUNT BLVD STE O
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-5822
Practice Address - Country:US
Practice Address - Phone:915-594-1123
Practice Address - Fax:877-724-3362
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC2950111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001172801Medicaid
TX601192Medicare PIN