Provider Demographics
NPI:1841228111
Name:ALLEN, KAREN ELIZABETH (OD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ELIZABETH
Last Name:ALLEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 DUMONT DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-6101
Mailing Address - Country:US
Mailing Address - Phone:972-307-5000
Mailing Address - Fax:972-307-7717
Practice Address - Street 1:3012 E HEBRON PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4464
Practice Address - Country:US
Practice Address - Phone:972-307-5000
Practice Address - Fax:972-307-7717
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6058TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83695EMedicare PIN
TXU87421Medicare UPIN