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General NPI Number Information
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NPI Number | 1861766966
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Entity Type | Individual
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Provider Name | AMY DEANN ALLAIRE M.P.T.
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Gender | Female
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Dates
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Enumeration Date | 03/07/2012
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Last Update Date | 03/07/2012
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Provider Practice Location Address
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Address Line | 502 CRYSTAL FALLS PKWY
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City | LEANDER
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State | TX
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Zip | 78641-1959
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Country | US
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Telephone | 512-528-0800
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Fax | 512-528-0460
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Provider Business Mailing Address
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Address Line | PO BOX 4649
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City | LAGO VISTA
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State | TX
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Zip | 78645-0054
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Country | US
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Telephone | 512-267-5400
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Fax | 512-267-5700
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1136158
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License Number State | TX
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