Individual
ALLEN D SU
Active
Individual
ALLEN D SU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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