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General NPI Number Information
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NPI Number | 1336660547
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Entity Type | Individual
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Provider Name | ALLISON LYNN TAPE DMD
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Gender | Female
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Dates
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Enumeration Date | 06/28/2017
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Last Update Date | 07/10/2023
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Provider Practice Location Address
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Address Line | 4765 FM 1960 RD W
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City | HOUSTON
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State | TX
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Zip | 77069-4641
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Country | US
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Telephone | 832-253-0999
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Fax |
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Provider Business Mailing Address
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Address Line | 14746 CHARLMONT DR
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City | HOUSTON
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State | TX
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Zip | 77083-5644
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Country | US
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Telephone |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN22724
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 33081
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License Number State | TX
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