Kahtonna Charvet Allen, M.S., D.O.
Individual provider Active NPI General Practice Physician · Fort Sam Houston, TX
NPI 1285867101 · NPPES record last updated Jun 7, 2013
Key facts
- NPI
- 1285867101
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- L1593644 (TX)
- Practice address
- 3851 Rodger Brooke Drive
Botsford General Hospital Dept of Medical Education
Fort Sam Houston, TX 78234 - Phone
- (210) 916-5554
- NPI assigned
- Aug 26, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151113002046 | GA | Order and Referring Only - Internal Medicine |
3173833514 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L1593644 | TX | MD | General Practice Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | L1593644 | TX | Yes |
Addresses
Primary practice location
3851 Rodger Brooke Drive
Botsford General Hospital Dept of Medical Education
Fort Sam Houston, TX 78234
Mailing address
6502 Dancing CT
San Antonio, TX 78244-1549
Other providers in Fort Sam Houston, TX
- Antwain Alexander
- Theresa Ann Alford
- Christopher L Allam
- Anthony Wayne Allen
- Jasmine Allen
- Katherine Elizabeth Allen
- Leonard Hamilton Allen III
- Paul Benjamin Allen Sr.
- William Roger Allen III
- Angela Ann Allerman
All providers in Fort Sam Houston, TX · General Practice Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 7, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.