Provider Demographics
NPI:1982032884
Name:ALLEN, SPENCER (CRNA)
Entity Type:Individual
Prefix:
First Name:SPENCER
Middle Name:
Last Name:ALLEN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 E CORNELL AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-5631
Mailing Address - Country:US
Mailing Address - Phone:480-748-8183
Mailing Address - Fax:
Practice Address - Street 1:216 E CORNELL AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-5631
Practice Address - Country:US
Practice Address - Phone:480-748-8183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-31
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ93322367500000X
TXAP124455367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered