Individual
ALLEN D SU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 W ARBROOK BLVD STE 240, ARLINGTON, TX 76014-3107
(817) 467-0240
(817) 472-9385
Mailing address
400 W ARBROOK BLVD STE 240, ARLINGTON, TX 76014-3107
(817) 467-0240
(817) 472-9385
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
J9222
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0075GG
BLUE CROSS BLUE SHIELD TX
TX
05
—
103018101
—
TX
05
—
103018103
—
TX
05
—
103018104
—
TX
Enumeration date
01/31/2007
Last updated
01/24/2011
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