Organization
ALLEN HOLISTIC PSYCHIATRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EVERETT ALLEN MPH, MHS, PA-C (OWNER OF ALLEN HOLISTIC PSYCHIATRY)
(704) 641-6584
Entity
Organization
Contact information
Practice address
122 GARDEN GROVE LN, RED OAK, TX 75154-0150
(704) 641-6584
Mailing address
122 GARDEN GROVE LN, RED OAK, TX 75154-0150
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1136154
NCCPA
—
Enumeration date
10/29/2019
Last updated
10/29/2019
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