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General NPI Number Information
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NPI Number | 1083656433
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Entity Type | Individual
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Provider Name | ALLAN DEAN PACKER MD
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Gender | Male
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 08/08/2018
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Provider Practice Location Address
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Address Line | 10309 ASHMONT DR
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City | FRISCO
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State | TX
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Zip | 75035
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Country | US
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Telephone | 937-508-9031
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Fax |
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Provider Business Mailing Address
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Address Line | 10309 ASHMONT DR
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City | FRISCO
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State | TX
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Zip | 75035-5221
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Country | US
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Telephone | 937-508-9031
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 23885
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | P5862
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License Number State | TX
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