Healthcare Provider Details

I. General information

NPI: 1639091374
Provider Name (Legal Business Name): ALLSTON TOOKES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4105 POSTGATE TER APT 303
SILVER SPRING MD
20906-6006
US

IV. Provider business mailing address

4105 POSTGATE TER APT 303
SILVER SPRING MD
20906-6006
US

V. Phone/Fax

Practice location:
  • Phone: 615-574-0096
  • Fax:
Mailing address:
  • Phone: 615-574-0096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberMD-10274324402
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: