Provider Demographics
NPI:1851826150
Name:ALLEN, TALAYIA (HAIR LOSS SPECIALIST)
Entity Type:Individual
Prefix:
First Name:TALAYIA
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:HAIR LOSS SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12353 BEAMER RD APT 603
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-5381
Mailing Address - Country:US
Mailing Address - Phone:262-497-3583
Mailing Address - Fax:
Practice Address - Street 1:12353 BEAMER RD APT 603
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-5381
Practice Address - Country:US
Practice Address - Phone:262-497-3583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-24
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17008121744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management