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ALLEGRA ANTWINE
Complete NPI Record 1730603150
Behavior Technician in Dallas, TX

NPI Status: Active since July 27, 2017

Contact Information

11661 PRESTON RD STE 260
DALLAS, TX
ZIP 75230
Phone: (469) 658-1819

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider Business Mailing Address Telephone Number
  11. Provider First Line Business Practice Location Address
  12. Provider Business Practice Location Address City Name
  13. Provider Business Practice Location Address State Name
  14. Provider Business Practice Location Address Postal Code
  15. Provider Business Practice Location Address Country Code If outside U S
  16. Provider Business Practice Location Address Telephone Number
  17. Provider Enumeration Date
  18. Last Update Date
  19. Provider Gender Code
  20. Healthcare Provider Taxonomy Code 1
  21. Healthcare Provider Primary Taxonomy Switch 1
  22. Is Sole Proprietor
  23. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1730603150. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1730603150
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Entity Type Code: 1
The city name in the location address of the provider being identified.
The State code in the location of the provider being identified.
Provider First Name: ALLEGRA
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider First Line Business Mailing Address: 11661 PRESTON RD STE 260
The country code in the location address of the provider being identified.
Provider Business Mailing Address City Name: DALLAS
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider Business Mailing Address State Name: TX
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address Postal Code: 752306108
The date the provider was assigned a unique identifier (assigned an NPI).
Provider Business Mailing Address Country Code If outside U S : US
The date that a record was last updated or changed.
Provider Business Mailing Address Telephone Number: 4696581819
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Provider First Line Business Practice Location Address: 11661 PRESTON RD STE 260
The first name of the authorized official.
Provider Business Practice Location Address City Name: DALLAS
The middle name of the authorized official.
Provider Business Practice Location Address State Name: TX
The title or position of the authorized official.
Provider Business Practice Location Address Postal Code: 752306108
The 10-position telephone number of the authorized official.
Provider Business Practice Location Address Country Code If outside U S : US
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider Business Practice Location Address Telephone Number: 4696581819
Provider Enumeration Date: 7/27/2017
Last Update Date: 6/16/2020
Provider Gender Code: F
Healthcare Provider Taxonomy Code 1: 106S00000X
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Healthcare Provider Primary Taxonomy Switch 1: Y
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Is Sole Proprietor: N
NPI Certification Date: 6/16/2020
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.