Provider Demographics
NPI:1194154120
Name:ALLIED TRI MED, LLC
Entity type:Organization
Organization Name:ALLIED TRI MED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MF
Authorized Official - Prefix:MR
Authorized Official - First Name:NIZAR
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALIKHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MG
Authorized Official - Phone:972-432-6550
Mailing Address - Street 1:14902 PRESTON RD
Mailing Address - Street 2:404-513
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-9191
Mailing Address - Country:US
Mailing Address - Phone:972-432-6550
Mailing Address - Fax:214-261-2217
Practice Address - Street 1:5710 LBJ FREEWAY
Practice Address - Street 2:325
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6398
Practice Address - Country:US
Practice Address - Phone:972-432-6550
Practice Address - Fax:214-261-2217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-12
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1001343OtherLICENSE #