Provider Demographics
NPI:1457527038
Name:ALLEN FAMILY WELLNESS LLC
Entity Type:Organization
Organization Name:ALLEN FAMILY WELLNESS LLC
Other - Org Name:ALLEN FAMILY WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-303-6800
Mailing Address - Street 1:2819 MEDLIN DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-2329
Mailing Address - Country:US
Mailing Address - Phone:817-303-6800
Mailing Address - Fax:817-303-6832
Practice Address - Street 1:2819 MEDLIN DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-2329
Practice Address - Country:US
Practice Address - Phone:817-303-6800
Practice Address - Fax:817-303-6832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9491111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU02127Medicare UPIN
TX611103Medicare PIN