Provider Demographics
NPI:1396884201
Name:ALLISON, MONICA LINETTE (OD)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:LINETTE
Last Name:ALLISON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 KNIGHTS CROSS DR
Mailing Address - Street 2:STE. 101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-2980
Mailing Address - Country:US
Mailing Address - Phone:210-495-9020
Mailing Address - Fax:210-495-9398
Practice Address - Street 1:810 KNIGHTS CROSS DR
Practice Address - Street 2:STE. 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-2980
Practice Address - Country:US
Practice Address - Phone:210-495-9020
Practice Address - Fax:210-495-9398
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5551TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU88761Medicare UPIN
TX8B4088Medicare ID - Type Unspecified