Provider Demographics
NPI:1962193011
Name:ALLEN MEDICAL ARTS PC
Entity type:Organization
Organization Name:ALLEN MEDICAL ARTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-545-6111
Mailing Address - Street 1:PO BOX 400278
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89140-0278
Mailing Address - Country:US
Mailing Address - Phone:702-545-6111
Mailing Address - Fax:702-727-8772
Practice Address - Street 1:5915 S RAINBOW BLVD STE 105
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-2558
Practice Address - Country:US
Practice Address - Phone:702-545-6111
Practice Address - Fax:702-727-8772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-18
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty