MEDICARE: DR. ANTHONY JAMAINE ALLEN D.C.

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	111NS0005X	Sports Physician Chiropractor	DC9136	TX

General Provider Information

NPI Number	:	1851535553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY JAMAINE ALLEN D.C.

Provider Business Mailing Address
First Line	:	6300 SAMUELL BLVD
Second Line	:	STE. 145
City	:	DALLAS
State	:	TX
Zip	:	75228-7137
Country	:	US
Telephone Number	:	214-751-8960
Fax Number	:	214-751-8965

Provider Business Practice Location Address
First Line	:	6300 SAMUELL BLVD
Second Line	:	STE. 145
City	:	DALLAS
State	:	TX
Zip	:	75228-7137
Country	:	US
Telephone Number	:	214-751-8960
Fax Number	:	214-751-8965

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

Provider Enumeration Date	:	04/24/2009
Last Update Date	:	04/24/2009

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