Larry Steve Allen, FNP
Individual provider Active NPI Family Nurse Practitioner · Texarkana, TX
NPI 1669714663 · NPPES record last updated Mar 18, 2013
Key facts
- NPI
- 1669714663
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- PENDED (TX)
- Practice address
- 2101 Galleria Oaks Dr
Texarkana, TX 75503-4625 - Phone
- (903) 791-9120
- Fax
- (903) 791-9132
- NPI assigned
- Mar 18, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Family Medical Group of Texarkana
Riverview Behavioral Health LLC
Practice addresses (Care Compare)
2101 Galleria Oaks Dr
Texarkana, TX 75503-4625
Phone (903) 791-9120
701 Arkansas Blvd
Texarkana, AR 71854-2105
Phone (870) 772-5028
Hospital & facility affiliations
- Heritage Home Health
- Elite Home Health
- Christus St Michael Health System
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX, AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130716000213 | TX | Practitioner - Nurse Practitioner | 4082854047 | Reassigns benefits to 1 organization |
| I20251013003049 | AR | Practitioner - Nurse Practitioner | 4082854047 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PENDED | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Medical Group of Texarkana | Current |
Accepting new patients | |
| Riverview Behavioral Health, LLC | Current |
Accepting new patients | |
| Riverview Behavioral Health, LLC | Current | Accepting new patients |
Locations
701 Arkansas Blvd
Texarkana, AR 71854
Phone (870) 772-5028
2101 Galleria Oaks Dr
Texarkana, TX 75503
Phone (903) 791-9120
5212 W 7th St
Wake Village, TX 75501
Phone (903) 791-9120
Interoperability endpoints
- larryallen@fmgt.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | PENDED | TX | Yes |
Addresses
Primary practice location
2101 Galleria Oaks Dr
Texarkana, TX 75503-4625
Mailing address
2101 Galleria Oaks Dr
Texarkana, TX 75503-4625
Phone (903) 791-9120
Other providers in Texarkana, TX
- Carey Christian Alkire
- Lauren Allday
- Bridget Allen
- Danette Allen
- Jill Allen
- Mark Allen
- Matt Allred
- Andrea Alston
- Thomas Alston
- America'S Medical Supply
All providers in Texarkana, TX · Family Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.