Individual provider Active NPI

Gary Edwin Allen, M.D.

  • Vascular & Interventional Radiology Physician
  • Little Rock, AR
National Provider Identifier
1063467256
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
J9611 Issued in TX
Practice address
13501 Chenal Pkwy Ste 102
Little Rock, AR 72211-5262
Phone
(281) 888-8999
Fax
(281) 305-4054
NPI assigned
May 24, 2006
Last updated
Jul 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X C8226 AR
Vascular & Interventional Radiology Physician 2085R0204X J9611 TX Primary

Addresses

Primary practice location

13501 Chenal Pkwy Ste 102
Little Rock, AR 72211-5262

Mailing address

P.O. Box 735863
Dallas, TX 75373-5863
Phone (281) 888-8999

Other practice location 1

3319 Unicorn Lake Blvd
Ste 111
Denton, TX 76210-0121
Phone (281) 888-8999

Other practice location 2

1810 Murchison Drive
Ste 104
El Paso, TX 79902-2906
Phone (281) 888-8999

Other practice location 3

1924 Forest Ridge Drive
Ste 300
Bedford, TX 76021-8228
Phone (281) 888-8999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060511000428 AR Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 8325938426 Reassigns benefits to 2 organizations
I20211108002285 TX Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 8325938426 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
University of Arkansas College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nirp Sugar Land PLLCGroup PAC ID 2163718727, 8 clinicians

Practice addresses (Care Compare)

7616 Branford PL
Suite 140
Sugar Land, TX 77479-3794
Phone (281) 888-8999

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)174

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C8226ARMDVascular & Interventional Radiology Physician
J9611TXMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nirp Laredo PLLC Vascular & Interventional Radiology CurrentSince Oct 3, 2022 Accepting new patients
Nirp Rio Grande Valley PLLC Vascular & Interventional Radiology CurrentSince Oct 3, 2022 Accepting new patients
Nirp Sugar Land PLLC Vascular & Interventional Radiology CurrentSince Oct 3, 2022 Accepting new patients
Nirp Woodlands PLLC Vascular & Interventional Radiology CurrentSince Oct 3, 2022 Accepting new patients
Nirp Victoria PLLC Vascular & Interventional Radiology CurrentSince Oct 3, 2022 Accepting new patients
Nirp Beaumont, PLLC Vascular & Interventional Radiology CurrentSince Oct 3, 2022 Accepting new patients
Nirp Corpus Christi PLLC Vascular & Interventional Radiology CurrentSince Oct 3, 2022 Accepting new patients
Radiology Consultants of Little Rock, PA CurrentSince Sep 1, 1999 Accepting new patients
Nirp Pasadena, PLLC Vascular & Interventional Radiology CurrentSince Oct 3, 2022 Accepting new patients
Nirp Dallas-Fort Worth PLLC Vascular & Interventional Radiology CurrentSince Oct 3, 2022 Accepting new patients
Nephrology Associates PA CurrentSince Feb 1, 2018 Accepting new patients
Harris and Theodore Anesthesia Services, LLC PastSince Feb 27, 2023 Accepting new patients
Shared Medical Services, Inc. Past Accepting new patients
Vascular Anesthesia Associates PLLC PastSince Oct 3, 2022 Accepting new patients
Cardiovascular Care Providers, Inc. Past Accepting new patients
Conway Radiology Consultants, LLC Past Accepting new patients

Locations

8907 Kanis Rd
Ste 330
Little Rock, AR 72205
Phone (501) 224-8810

9601 Baptist Health Dr
Ste 1100
Little Rock, AR 72205
Phone (501) 748-3210

3401 Springhill Dr
Ste 325
North Little Rock, AR 72117
Phone (501) 955-0320

755 S 11th St
Ste 100A
Beaumont, TX 77701
Phone (409) 729-8088

1924 Forest Ridge Dr
Ste 300
Bedford, TX 76021

2501 Paredes Rd
Ste B7
Brownsville, TX 78526

7101 S Staples St
Corpus Christi, TX 78413
Phone (361) 814-9898

7101 S Staples St
Ste 101
Corpus Christi, TX 78413
Phone (361) 985-0323

1341 W Mockingbird Ln
Dallas, TX 75247
Phone (214) 217-7520

3319 Unicorn Lake Blvd
Ste 111
Denton, TX 76210
Phone (866) 490-3668

1955 E Main St
Eagle Pass, TX 78852
Phone (830) 773-7474

2800 W Trenton Rd
Ste 2868
Edinburg, TX 78539

1810 Murchison Dr
Ste 104
El Paso, TX 79902
Phone (280) 888-8999

1502 Midlane Dr
Ste 111
Harlingen, TX 78552
Phone (512) 287-1532

6419 Polaris Dr
#B2
Laredo, TX 78041

6419 Polaris Dr
Ste B2
Laredo, TX 78041

2270 Matlock Rd
Ste 104
Mansfield, TX 76063
Phone (325) 480-2063

3412 Burke Rd
#100
Pasadena, TX 77504

2764 Pharmacy Rd
Rio Grande Cy, TX 78582
Phone (956) 352-1150

7616 Branford Pl
Ste 140
Sugar Land, TX 77479
Phone (817) 605-9310

17191 St Lukes Way
Ste 280
The Woodlands, TX 77384
Phone (936) 202-1260

1908 N Laurent St
Ste 120
Victoria, TX 77901
Phone (361) 576-4673

Organizations & group practices 17

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1063467256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 735863",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753735863",
            "telephone_number": "281-888-8999",
            "fax_number": "281-305-4054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13501 CHENAL PKWY STE 102",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722115262",
            "telephone_number": "281-888-8999",
            "fax_number": "281-305-4054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3319 Unicorn Lake Blvd",
            "address_2": "Ste 111",
            "address_purpose": "LOCATION",
            "city": "Denton",
            "state": "TX",
            "postal_code": "762100121",
            "country_code": "US",
            "telephone_number": "281-888-8999",
            "fax_number": "281-305-4054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1810 Murchison Drive",
            "address_2": "Ste 104",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799022906",
            "country_code": "US",
            "telephone_number": "281-888-8999",
            "fax_number": "281-305-4054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1924 Forest Ridge Drive",
            "address_2": "Ste 300",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "TX",
            "postal_code": "760218228",
            "country_code": "US",
            "telephone_number": "281-888-8999",
            "fax_number": "281-305-4054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "GARY",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "AR",
            "license": "C8226",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TX",
            "license": "J9611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.