Provider Demographics
NPI:1245517556
Name:DINSMORE, ALLAN LEWIS II (OPA-C, ATC, LAT)
Entity type:Individual
Prefix:MR
First Name:ALLAN
Middle Name:LEWIS
Last Name:DINSMORE
Suffix:II
Gender:M
Credentials:OPA-C, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10521 CONDOR LOOP
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76708-7288
Mailing Address - Country:US
Mailing Address - Phone:830-377-7621
Mailing Address - Fax:
Practice Address - Street 1:10521 CONDOR LOOP
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-7288
Practice Address - Country:US
Practice Address - Phone:830-377-7621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-15
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT17932255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer