Active NPI
Thomas W Allen, LAT
- Athletic Trainer
- Del Valle, TX
National Provider Identifier
1053956995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT0824
- Practice address
- 5201 Ross Rd
Del Valle, TX 78617-3202 - Phone
- (512) 386-3261
- Fax
- (512) 386-3489
- NPI assigned
- Nov 14, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT0824 | TX | Primary |
Addresses
Primary practice location
5201 Ross Rd
Del Valle, TX 78617-3202
Mailing address
8651 Barrow Glen Loop
Austin, TX 78749-3623
Phone (512) 750-3673
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Austin |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT0824 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573689600000",
"number": "1053956995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8651 BARROW GLEN LOOP",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787493623",
"telephone_number": "512-750-3673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5201 ROSS RD",
"city": "DEL VALLE",
"state": "TX",
"postal_code": "786173202",
"telephone_number": "512-386-3261",
"fax_number": "512-386-3489"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "THOMAS",
"middle_name": "W",
"name_prefix": "Mr.",
"credential": "LAT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-11-14",
"last_updated": "2019-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT0824",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Austin",
"affiliation": "N",
"address_1": "8651 Barrow Glen Loop",
"city": "Austin",
"state": "TX",
"country_code": "US",
"postal_code": "787493623",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Del Valle, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.