Allen Holistic Psychiatry, PLLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

ALLEN HOLISTIC PSYCHIATRY, PLLC

Practice address

122 Garden Grove LN
Red Oak, TX 75154-0150

Phone

(704) 641-6584

NPI assigned

Oct 29, 2019

Last updated

Oct 29, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Everett Allen, MPH, MHS, PA-CNPI 1982154324

Title

Owner of Allen Holistic Psychiatry

Phone

(704) 641-6584

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Everett Allen, PA-C

  • Physician Assistant
  • Eureka, CA
  • NPI 1982154324
  NPD Authorized official

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572307200000",
    "number": "1821632290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 GARDEN GROVE LN",
            "city": "RED OAK",
            "state": "TX",
            "postal_code": "751540150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 GARDEN GROVE LN",
            "city": "RED OAK",
            "state": "TX",
            "postal_code": "751540150",
            "telephone_number": "704-641-6584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "122 Garden Grove Ln",
            "address_purpose": "LOCATION",
            "city": "Red Oak",
            "state": "TX",
            "postal_code": "751540150",
            "country_code": "US",
            "telephone_number": "704-641-6584",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ALLEN HOLISTIC PSYCHIATRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-29",
        "last_updated": "2019-10-29",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "EVERETT",
        "authorized_official_title_or_position": "OWNER OF ALLEN HOLISTIC PSYCHIATRY",
        "authorized_official_telephone_number": "704-641-6584",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPH, MHS, PA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1136154",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eallen@allenholisticpsychiatry.com",
            "affiliation": "N",
            "address_1": "122 Garden Grove Ln",
            "city": "Red Oak",
            "state": "TX",
            "country_code": "US",
            "postal_code": "751540150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physician Assistant in Red Oak, TX
• Providers in Red Oak, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; 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.