Provider Demographics
NPI:1023128048
Name:ARMENTROUT, ALAN LEE (NP-C)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:LEE
Last Name:ARMENTROUT
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3329 KELSEY CT
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2935
Mailing Address - Country:US
Mailing Address - Phone:972-975-2324
Mailing Address - Fax:
Practice Address - Street 1:8200 N MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-4889
Practice Address - Country:US
Practice Address - Phone:972-975-2324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC3078111N00000X
TXAP129669363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
601337Medicare ID - Type Unspecified