MEDICARE: ALLISON JOY ESENWINE MD

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	207P00000X	Emergency Medicine Physician	M3216	TX

General Provider Information

NPI Number	:	1891719407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON JOY ESENWINE MD

Provider Business Mailing Address
First Line	:	3001 WESTMINSTER AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75205-1422
Country	:	US
Telephone Number	:	214-361-7637
Fax Number	:

Provider Business Practice Location Address
First Line	:	1717 MAIN ST
Second Line	:	SUITE 5200
City	:	DALLAS
State	:	TX
Zip	:	75201-4612
Country	:	US
Telephone Number	:	214-712-2019
Fax Number	:

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	02/20/2024

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