Healthcare Provider Details

I. General information

NPI: 1659604890
Provider Name (Legal Business Name): ANDREA ALLEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANDREA FRITZ MD

II. Dates (important events)

Enumeration Date: 09/04/2009
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 TOWN CENTER BLVD STE 300
JARRELL TX
76537-4002
US

IV. Provider business mailing address

PO BOX 844658
DALLAS TX
75284-4658
US

V. Phone/Fax

Practice location:
  • Phone: 512-746-2690
  • Fax: 888-254-4802
Mailing address:
  • Phone: 254-724-2111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberL1321
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: