Provider Demographics
NPI:1548891898
Name:SPEED, ALLISON FAYE (NP)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:FAYE
Last Name:SPEED
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 PR 2010
Mailing Address - Street 2:
Mailing Address - City:GILMER
Mailing Address - State:TX
Mailing Address - Zip Code:75645-7542
Mailing Address - Country:US
Mailing Address - Phone:605-219-7570
Mailing Address - Fax:
Practice Address - Street 1:326 PR 2010
Practice Address - Street 2:
Practice Address - City:GILMER
Practice Address - State:TX
Practice Address - Zip Code:75645-7542
Practice Address - Country:US
Practice Address - Phone:605-219-7570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF01200061207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine