MEDICARE: COURTNEY BAYER ALLEN PT, DPT

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	225100000X	Physical Therapist	1206476	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	874T73	OTHER	TX	BLUE CROSS BLUE SHIELD OF TEXAS

General Provider Information

NPI Number	:	1639466089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY BAYER ALLEN PT, DPT

Provider Business Mailing Address
First Line	:	9109 ARBOR TRAIL DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-6357
Country	:	US
Telephone Number	:	214-476-3311
Fax Number	:

Provider Business Practice Location Address
First Line	:	9109 ARBOR TRAIL DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-6357
Country	:	US
Telephone Number	:	214-476-3311
Fax Number	:

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

Provider Enumeration Date	:	07/06/2011
Last Update Date	:	02/19/2021

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