Provider Demographics
NPI:1679658298
Name:COHEN, ALLISON R (DC, CCSP)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:R
Last Name:COHEN
Suffix:
Gender:F
Credentials:DC, CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1149 PRECINCT LINE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76053-4288
Mailing Address - Country:US
Mailing Address - Phone:817-284-2827
Mailing Address - Fax:817-589-8548
Practice Address - Street 1:1149 PRECINCT LINE RD
Practice Address - Street 2:SUITE C
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76053-4288
Practice Address - Country:US
Practice Address - Phone:817-284-2827
Practice Address - Fax:817-589-8548
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6533111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8R9170OtherBC/BS
TXU60733Medicare UPIN
TX8E0228Medicare ID - Type Unspecified