Organization Active NPI

Gwendolyn J. Allen, MD, PA

  • Family Medicine Physician
  • Brownwood, TX
National Provider Identifier
1346572880
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GWENDOLYN J. ALLEN, MD, PA
Practice address
1604 14TH St
Brownwood, TX 76801-5314
Phone
(325) 646-5296
Fax
(325) 646-5820
NPI assigned
Feb 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2021

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

Authorized official

Name
Gwendolyn Joyce Allen, M.D.
Title
Owner
Phone
(325) 646-5296

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X G4784 TX
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary
Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363A00000X
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

1604 14TH St
Brownwood, TX 76801-5314

Mailing address

1604 14TH St
Brownwood, TX 76801-5314
Phone (325) 646-5296

Other identifiers 1

IdentifierTypeStateIssuer
214607802MedicaidTX

National Provider Directory

National Provider Directory

Locations

1604 14th St
Brownwood, TX 76801
Phone (325) 646-5296

NPI Registry JSON

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

{
    "created_epoch": "1265673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622073600000",
    "number": "1346572880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 14TH ST",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "768015314",
            "telephone_number": "325-646-5296",
            "fax_number": "325-646-5820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 14TH ST",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "768015314",
            "telephone_number": "325-646-5296",
            "fax_number": "325-646-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GWENDOLYN J. ALLEN, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-09",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_middle_name": "JOYCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "325-646-5296",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G4784",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214607802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownwood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.