Provider Demographics
NPI:1881037158
Name:ALLGAIER, BRIAN
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:ALLGAIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 841656
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-1656
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 E DAWSON ST
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-2036
Practice Address - Country:US
Practice Address - Phone:903-531-4262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-16
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX574840207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX75-2616977-001OtherTRICARE
TX344080215Medicaid
TX75-0818167-015OtherTRICARE
TXP01697302OtherRAIL ROAD MEDICARE
TX344080212Medicaid
TX75-0818167-048OtherTRICARE
TX75-2616977-028OtherTRICARE
TX8GC433OtherBCBS
TX344080214Medicaid
TX8GC430OtherBCBS
TXP01697219OtherRAIL ROAD MEDICARE
TXP01697263OtherRAIL ROAD MEDICARE
TX574840OtherTEXAS MEDICAL BOARD PHYSICIAN IN TRAINING PERMIT
TX8GC431OtherBCBS
TX344080213Medicaid
TX75-0818167-022OtherTRICARE
TX75-0818167-044OtherTRICARE
TX8GC432OtherBCBS
TX75-2616977-002OtherTRICARE
TX394319YNSXMedicare PIN
TX8GC433OtherBCBS
TX344080215Medicaid
TX344080214Medicaid