Healthcare Provider Details

I. General information

NPI: 1881538171
Provider Name (Legal Business Name): MARINDA ALLEN DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 MACOMB RD
FORT SILL OK
73503-4424
US

IV. Provider business mailing address

721 MACOMB RD
FORT SILL OK
73503-4424
US

V. Phone/Fax

Practice location:
  • Phone: 580-442-3416
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number18064
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number11969
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: