Provider Demographics
NPI:1285488080
Name:ALLEN INTERNAL MEDICINE PLLC
Entity type:Organization
Organization Name:ALLEN INTERNAL MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SATISH
Authorized Official - Middle Name:
Authorized Official - Last Name:BAGDURE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-252-1883
Mailing Address - Street 1:931 STATE HIGHWAY 121 APT 4300
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-1193
Mailing Address - Country:US
Mailing Address - Phone:806-252-1883
Mailing Address - Fax:
Practice Address - Street 1:931 STATE HIGHWAY 121 APT 4300
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-1193
Practice Address - Country:US
Practice Address - Phone:806-252-1883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-16
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty