Provider Demographics
NPI:1992302251
Name:APL MED PLLC
Entity type:Organization
Organization Name:APL MED PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:DEWAYNE
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:936-465-6404
Mailing Address - Street 1:111 E SHEPHERD AVE
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75901-0315
Mailing Address - Country:US
Mailing Address - Phone:936-465-6404
Mailing Address - Fax:
Practice Address - Street 1:111 E SHEPHERD AVE
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75901-0315
Practice Address - Country:US
Practice Address - Phone:936-465-6404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty