Provider Demographics
NPI:1932583259
Name:ALLEN, DANA LYNN (ATC, LAT,CPHT,NREMT)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:LYNN
Last Name:ALLEN
Suffix:
Gender:F
Credentials:ATC, LAT,CPHT,NREMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7317 POST OAK DR
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-3443
Mailing Address - Country:US
Mailing Address - Phone:817-320-6511
Mailing Address - Fax:
Practice Address - Street 1:7317 POST OAK DR
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-3443
Practice Address - Country:US
Practice Address - Phone:817-320-6511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX721899146N00000X
TX09852255A2300X
TX173666183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No183700000XPharmacy Service ProvidersPharmacy Technician