MEDICARE: DR. COBURN HUCKINS ALLEN 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	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	K2637	TX
2	208000000X	Pediatrics Physician	K2637	TX
3	2080P0208X	Pediatric Infectious Diseases Physician	K2637	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114923984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COBURN HUCKINS ALLEN M.D.

Provider Business Mailing Address
First Line	:	4900 MUELLER BLVD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78723-3079
Country	:	US
Telephone Number	:	512-324-0093
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 BARBARA JORDAN BLVD
Second Line	:	SUITE 200
City	:	AUSTIN
State	:	TX
Zip	:	78723-3077
Country	:	US
Telephone Number	:	512-628-1800
Fax Number	:

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

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	08/02/2013

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