Provider Demographics
NPI:1215048814
Name:ALLEN, STEPHEN CRAIG (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:CRAIG
Last Name:ALLEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6406 HIGHWAY 78 STE 100
Mailing Address - Street 2:
Mailing Address - City:SACHSE
Mailing Address - State:TX
Mailing Address - Zip Code:75048-3203
Mailing Address - Country:US
Mailing Address - Phone:214-227-5155
Mailing Address - Fax:214-227-5225
Practice Address - Street 1:6406 HIGHWAY 78 STE 100
Practice Address - Street 2:
Practice Address - City:SACHSE
Practice Address - State:TX
Practice Address - Zip Code:75048-3203
Practice Address - Country:US
Practice Address - Phone:214-227-5155
Practice Address - Fax:214-227-5225
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6833111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX142491301Medicaid
TX8U1740OtherNPIN-B.C.B.S.
TXU61852Medicare UPIN
TX142491301Medicaid