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NPI Code Detail

MEDICARE: DR. NANETTE N ALLISON D.O.

MEDICARE: DR. NANETTE N ALLISON D.O.
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
12084P0804XChild & Adolescent Psychiatry PhysicianN4245TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
38DT471OTHERTXBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1942469143
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NANETTE N ALLISON D.O.
Provider Business Mailing Address
First Line : 601 W TERRELL AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-3243
Country : US
Telephone Number : 817-702-3100
Fax Number :
Provider Business Practice Location Address
First Line : 601 W TERRELL AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-3243
Country : US
Telephone Number : 817-702-3100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2008
Last Update Date : 05/06/2024

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