Provider Demographics
NPI:1609846641
Name:ALLEN, EVERETT HUNTER (MD)
Entity Type:Individual
Prefix:
First Name:EVERETT
Middle Name:HUNTER
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19272 STONE OAK PKWY
Mailing Address - Street 2:STE 101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3371
Mailing Address - Country:US
Mailing Address - Phone:210-265-8851
Mailing Address - Fax:210-265-8855
Practice Address - Street 1:19272 STONE OAK PKWY
Practice Address - Street 2:STE 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3371
Practice Address - Country:US
Practice Address - Phone:210-265-8851
Practice Address - Fax:210-265-8855
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1260207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8S2551OtherBCBS
TX0043MQOtherBCBS
TX8S2551OtherBCBS