Provider Demographics
NPI:1922302421
Name:ALLEN, ELVEREZ II
Entity Type:Individual
Prefix:
First Name:ELVEREZ
Middle Name:
Last Name:ALLEN
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17512 HIGHWAY 6
Mailing Address - Street 2:SUTE F7
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-3752
Mailing Address - Country:US
Mailing Address - Phone:214-621-5873
Mailing Address - Fax:
Practice Address - Street 1:17512 HIGHWAY 6
Practice Address - Street 2:SUTE F7
Practice Address - City:MANVEL
Practice Address - State:TX
Practice Address - Zip Code:77578-3752
Practice Address - Country:US
Practice Address - Phone:214-621-5873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-27
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies