MEDICARE: DR. ALLISON BECKWORTH READINGER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	M4467	TX
2	207ND0900X	Dermatopathology Physician	M4467	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8J3741	OTHER	TX	BLUE CROSS BLUE SHIELD OF TEXAS

General Provider Information

NPI Number	:	1033256821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLISON BECKWORTH READINGER M.D.

Provider Business Mailing Address
First Line	:	800 8TH AVE STE 326
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-2602
Country	:	US
Telephone Number	:	817-885-8222
Fax Number	:	817-885-8663

Provider Business Practice Location Address
First Line	:	800 8TH AVE STE 326
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-2602
Country	:	US
Telephone Number	:	817-885-8222
Fax Number	:	817-885-8663

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	05/10/2011

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