Provider Demographics
NPI:1821074212
Name:ALLEN CHIROPRACTIC NEUROLOGY INC
Entity Type:Organization
Organization Name:ALLEN CHIROPRACTIC NEUROLOGY INC
Other - Org Name:ALLEN CHIROPRACTIC NEUROLOGY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER / CHIROPRACTIC NEUROLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DAC, NB
Authorized Official - Phone:512-863-2225
Mailing Address - Street 1:2803 WILLIAMS DR
Mailing Address - Street 2:STE 105
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-2733
Mailing Address - Country:US
Mailing Address - Phone:512-863-2225
Mailing Address - Fax:512-863-2233
Practice Address - Street 1:2803 WILLIAMS DR
Practice Address - Street 2:STE 105
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-2733
Practice Address - Country:US
Practice Address - Phone:512-863-2225
Practice Address - Fax:512-863-2233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6629111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
8R8120OtherBC/BS
U60513Medicare UPIN
8D2513Medicare ID - Type Unspecified