Provider Demographics
NPI:1669716569
Name:COLEMAN, ALLISON KIRBY (OD)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:KIRBY
Last Name:COLEMAN
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 1:6000 TOWN EAST MALL
Mailing Address - Street 2:ATTN JC PENNEY OPTICAL
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150
Mailing Address - Country:US
Mailing Address - Phone:972-686-2555
Mailing Address - Fax:
Practice Address - Street 1:6000 TOWN EAST MALL
Practice Address - Street 2:ATTN: JC PENNEY OPTICAL
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150
Practice Address - Country:US
Practice Address - Phone:972-686-2555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8064T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist