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General NPI Number Information
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NPI Number | 1063424919
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Entity Type | Individual
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Provider Name | AJIT J ALLES M.B.B.S., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 04/06/2016
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Provider Practice Location Address
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Address Line | 801 7TH AVE
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City | FORT WORTH
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State | TX
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Zip | 76104-2733
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Country | US
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Telephone | 682-885-4289
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Fax | 682-885-6111
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Provider Business Mailing Address
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Address Line | PO BOX 99371
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City | FORT WORTH
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State | TX
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Zip | 76199-0371
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Country | US
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Telephone | 682-885-1855
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Fax | 682-885-7347
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0213X
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Taxonomy Name | Pediatric Pathology Physician
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License Number | K3970
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License Number State | TX
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