MEDICARE: DR. ROB ALLEN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	26468	TX

General Provider Information

NPI Number	:	1639230972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROB ALLEN DDS

Provider Business Mailing Address
First Line	:	3023 THOUSAND OAKS DR
Second Line	:	STE 110
City	:	SAN ANTONIO
State	:	TX
Zip	:	78247-3556
Country	:	US
Telephone Number	:	210-497-6700
Fax Number	:	210-497-6706

Provider Business Practice Location Address
First Line	:	3023 THOUSAND OAKS DR
Second Line	:	STE 110
City	:	SAN ANTONIO
State	:	TX
Zip	:	78247-3556
Country	:	US
Telephone Number	:	210-497-6700
Fax Number	:	210-497-6706

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	08/05/2011

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