Healthcare Provider Details

I. General information

NPI: 1194154120
Provider Name (Legal Business Name): ALLIED TRI MED, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2013
Last Update Date: 05/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5710 LBJ FREEWAY 325
DALLAS TX
75240-6398
US

IV. Provider business mailing address

14902 PRESTON RD 404-513
DALLAS TX
75254-9191
US

V. Phone/Fax

Practice location:
  • Phone: 972-432-6550
  • Fax: 214-261-2217
Mailing address:
  • Phone: 972-432-6550
  • Fax: 214-261-2217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. NIZAR A ALIKHAN
Title or Position: MF
Credential: MG
Phone: 972-432-6550