Provider Demographics
NPI:1548257819
Name:GILBERT, ALLAN DAVID (MD)
Entity type:Individual
Prefix:
First Name:ALLAN
Middle Name:DAVID
Last Name:GILBERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ALLAN
Other - Middle Name:D
Other - Last Name:GILBERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:10 MEDICAL PKWY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7840
Mailing Address - Country:US
Mailing Address - Phone:972-243-7901
Mailing Address - Fax:972-243-2069
Practice Address - Street 1:10 MEDICAL PKWY
Practice Address - Street 2:SUITE 204
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7840
Practice Address - Country:US
Practice Address - Phone:972-243-7901
Practice Address - Fax:972-243-2069
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD5740207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00T920Medicare ID - Type Unspecified
C16097Medicare UPIN