Healthcare Provider Details

I. General information

NPI: 1699549972
Provider Name (Legal Business Name): ALLYSON ROBERTSON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2023
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10763 COUNTY ROAD 127 STE B
FLINT TX
75762-7032
US

IV. Provider business mailing address

10763 COUNTY ROAD 127 STE B
FLINT TX
75762-7032
US

V. Phone/Fax

Practice location:
  • Phone: 903-521-3248
  • Fax: 855-840-8199
Mailing address:
  • Phone: 903-521-3248
  • Fax: 855-840-8199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State

VIII. Authorized Official

Name: ALLYSON ROBERTSON
Title or Position: OWNER/ CONSULTANT
Credential: RN,IBCLC
Phone: 903-521-3248