Provider Demographics
NPI:1639282437
Name:ALLON, MOSHE (MD)
Entity type:Individual
Prefix:
First Name:MOSHE
Middle Name:
Last Name:ALLON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 NASA PARKWAY
Mailing Address - Street 2:
Mailing Address - City:NASSAU BAY
Mailing Address - State:TX
Mailing Address - Zip Code:77058
Mailing Address - Country:US
Mailing Address - Phone:281-338-7246
Mailing Address - Fax:281-335-5706
Practice Address - Street 1:1202 NASA PARKWAY
Practice Address - Street 2:
Practice Address - City:NASSAU BAY
Practice Address - State:TX
Practice Address - Zip Code:77058
Practice Address - Country:US
Practice Address - Phone:281-338-7246
Practice Address - Fax:281-335-5706
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ24782084N0400X, 2084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00U47ZOtherMEDICARE
TX085668401Medicaid
F23786Medicare UPIN