Healthcare Provider Details

I. General information

NPI: 1598950040
Provider Name (Legal Business Name): DOUGLAS GREGORY ALLEN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: GREG ALLEN PHD

II. Dates (important events)

Enumeration Date: 09/07/2007
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 W 38TH ST STE F2
AUSTIN TX
78705-1133
US

IV. Provider business mailing address

711 W 38TH ST STE F2
AUSTIN TX
78705-1133
US

V. Phone/Fax

Practice location:
  • Phone: 512-637-5841
  • Fax: 512-637-5997
Mailing address:
  • Phone: 512-637-5841
  • Fax: 512-637-5997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number33416
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: