Healthcare Provider Details

I. General information

NPI: 1760290068
Provider Name (Legal Business Name): ALLYSON DANNETTE TORRES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2024
Last Update Date: 12/19/2024
Certification Date: 12/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 MUELLER BLVD
AUSTIN TX
78723-3051
US

IV. Provider business mailing address

17916 KENAI FJORDS DR APT 2
PFLUGERVILLE TX
78660-5330
US

V. Phone/Fax

Practice location:
  • Phone: 512-324-0000
  • Fax:
Mailing address:
  • Phone: 305-282-3047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number1181877
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: