Provider Demographics
NPI:1790185825
Name:ALLRED, STEVEN (CCC-A)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:ALLRED
Suffix:
Gender:M
Credentials:CCC-A
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 2533
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79105-2533
Mailing Address - Country:US
Mailing Address - Phone:806-355-5625
Mailing Address - Fax:806-352-2245
Practice Address - Street 1:3501 S SONCY RD
Practice Address - Street 2:SUITE 140
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-6407
Practice Address - Country:US
Practice Address - Phone:806-355-5625
Practice Address - Fax:806-352-2245
Is Sole Proprietor?:No
Enumeration Date:2014-08-26
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80632231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX386055YM5UMedicare UPIN