Healthcare Provider Details

I. General information

NPI: 1073437778
Provider Name (Legal Business Name): ALLISON GAGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 N PRESTON RD
PROSPER TX
75078-9826
US

IV. Provider business mailing address

804 FAIRVIEW CIR
KRUGERVILLE TX
76227-2811
US

V. Phone/Fax

Practice location:
  • Phone: 945-277-1048
  • Fax:
Mailing address:
  • Phone: 469-544-5801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-527939
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: