Individual
ALLISON MICHELLE TRAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
P O BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10147
TX
363A00000X
Physician Assistant
PA12293
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
350178503
—
TX
01
—
350178504
MEDICAID CSHCN
TX
05
—
391716301
—
TX
01
—
391716302
CSHCN- MEDICAID
TX
Enumeration date
09/06/2018
Last updated
02/08/2019
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