Individual ProviderStacey AllenAnesthesiologyAllopathic & Osteopathic PhysiciansPractice Address4502 Medical Dr, San Antonio, TX 78229-4402(210) 592-0400(210) 358-4000PECOS EnrollmentBased on the most recent information from CMS, provider Stacey Allen is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1093820904Provider TypeIndividualFull NameAllen, StaceyCredentialMDGenderFemaleSole ProprietorNoEnumeration Date8/20/2006Last Updated5/26/2020Contact InformationPractice LocationPractice Address4502 Medical Dr, San Antonio, TX 78229-4402Phone(210) 592-0400FaxUnlisted FaxMailing LocationMailing Address4502 Medical Dr Ste 900, San Antonio, TX 78229-4402Phone(210) 358-4000FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207L00000XPrimaryDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicenseJ7743TexasCode207LP3000XDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicenseJ7743TexasProvider IdentifiersIDDescriptionIssuerIDP00269860DescriptionOtherIssuerMEDICARE RAILROADTexasID039738210DescriptionMedicaidIssuerUnlistedTexasID039738202DescriptionMedicaidIssuerUnlistedTexasID039738203DescriptionOtherIssuerCSHCNTexas