Provider Demographics
NPI:1821136862
Name:KOGAN, ALLAN JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:JAY
Last Name:KOGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:3225 TURTLE CREEK BLVD
Mailing Address - Street 2:UNIT 1547
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-5400
Mailing Address - Country:US
Mailing Address - Phone:832-236-4160
Mailing Address - Fax:
Practice Address - Street 1:8350 N CENTRAL EXPY
Practice Address - Street 2:M1000
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-1600
Practice Address - Country:US
Practice Address - Phone:972-813-7072
Practice Address - Fax:866-213-7130
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXE2660207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine