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NPI Code Detail

MEDICARE: ALLISON MYERS-FABIAN PHD

MEDICARE: ALLISON MYERS-FABIAN PHD
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
1103G00000XClinical Neuropsychologist36885TX

General Provider Information

NPI Number : 1659683845
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON MYERS-FABIAN PHD
Provider Business Mailing Address
First Line : PO BOX 844658
Second Line :
City : DALLAS
State : TX
Zip : 75284-4658
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 200 MEDICAL PKWY STE 320
Second Line :
City : LAKEWAY
State : TX
Zip : 78738-1794
Country : US
Telephone Number : 512-654-0270
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2010
Last Update Date : 05/25/2021

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