Healthcare Provider Details

I. General information

NPI: 1447250345
Provider Name (Legal Business Name): ALYSON L DENSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 10/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E 6TH ST
TEXARKANA AR
71854-5207
US

IV. Provider business mailing address

300 E 6TH ST
TEXARKANA AR
71854-5207
US

V. Phone/Fax

Practice location:
  • Phone: 870-779-6000
  • Fax: 903-779-6125
Mailing address:
  • Phone: 870-779-6000
  • Fax: 903-779-6125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberE2840
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: