Allie Rose Hawkins, LAT, ATC

Individual provider Active NPI Sports Medicine (Emergency Medicine) Physician · Melissa, TX

NPI 1093433385 · NPPES record last updated Aug 22, 2022

Key facts

NPI
1093433385
Entity type
Individual (NPI type 1)
Primary specialty
Sports Medicine (Emergency Medicine) Physician 207PS0010X
License
AT7428 (TX)
Practice address
2700 Kennedy Dr
Melissa, TX 75454-2500
Phone
(951) 790-6184
NPI assigned
Aug 22, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
AT7428TXMDSports Medicine (Emergency Medicine) Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Emergency Medicine) Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207PS0010X AT7428 TX Yes

Addresses

Primary practice location

2700 Kennedy Dr
Melissa, TX 75454-2500

Mailing address

2700 Kennedy Dr
Melissa, TX 75454-2500
Phone (951) 790-6184

Other providers in Melissa, TX

All providers in Melissa, TX · Sports Medicine (Emergency Medicine) Physician in Texas

Sources for this page

Verify at the official NPI Registry.