MEDICARE: ALLISON BOLLINGER

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	363AM0700X	Medical Physician Assistant	PA20353	TX

General Provider Information

NPI Number	:	1184568842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON BOLLINGER

Provider Business Mailing Address
First Line	:	14616 DONNER TRL
Second Line	:
City	:	ROANOKE
State	:	TX
Zip	:	76262-2155
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2020 W STATE HIGHWAY 114 STE 310
Second Line	:
City	:	GRAPEVINE
State	:	TX
Zip	:	76051-8650
Country	:	US
Telephone Number	:	817-481-8100
Fax Number	:

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

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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Directions to “ ALLISON BOLLINGER ” Practice Location

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