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General NPI Number Information
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NPI Number | 1578348397
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Entity Type | Organization
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Legal Business Name | ALLELE HEALTHCARE INC
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Dates
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Enumeration Date | 08/29/2023
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 201 FLORENCE DR
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City | LEWISVILLE
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State | TX
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Zip | 75056-5880
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Country | US
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Telephone | 214-909-9772
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Fax | 972-767-4826
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Provider Business Mailing Address
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Address Line | 5049 EDWARDS RANCH RD FL 4
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City | FORT WORTH
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State | TX
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Zip | 76109-4213
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Country | US
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Telephone | 214-909-9772
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. TYLER STOUT
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Credential |
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Telephone | 337-315-7927
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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