Individual
ALLEN ALVA ERISMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3100 N TENAYA WAY, LAS VEGAS, NV 89128-0436
(972) 915-3600
(972) 915-3636
Mailing address
9229 LBJ FWY, STE 250, DALLAS, TX 75243-3405
(800) 346-0747
(972) 739-2638
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
02002084A
IN
207P00000X
Emergency Medicine Physician
Primary
1135
NV
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
1135
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100502406
—
NV
01
—
CC7823
BCBS
NV
Enumeration date
05/23/2005
Last updated
10/01/2014
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