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General NPI Number Information
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NPI Number | 1891753232
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Entity Type | Individual
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Provider Name | JERRY ALVIN ALLISON MD
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Gender | Male
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 02/05/2014
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Provider Practice Location Address
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Address Line | 13330 NOEL RD UNIT 338
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City | DALLAS
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State | TX
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Zip | 75240-5055
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Country | US
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Telephone | 916-897-4987
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Fax |
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Provider Business Mailing Address
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Address Line | 13330 NOEL RD UNIT 338
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City | DALLAS
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State | TX
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Zip | 75240-5055
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Country | US
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Telephone | 916-897-4987
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 13157
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A103638
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | P7380
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License Number State | TX
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