Provider Demographics
NPI:1912213778
Name:ALLISON READINGER MD PA
Entity Type:Organization
Organization Name:ALLISON READINGER MD PA
Other - Org Name:TRINITY VISTA DERMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:BECKWORTH
Authorized Official - Last Name:READINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-885-8222
Mailing Address - Street 1:800 8TH AVE STE 326
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-2602
Mailing Address - Country:US
Mailing Address - Phone:817-885-8222
Mailing Address - Fax:
Practice Address - Street 1:800 8TH AVE STE 326
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2602
Practice Address - Country:US
Practice Address - Phone:817-885-8222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-30
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4467261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty