Provider Demographics
NPI:1033833629
Name:ALLERGY & CLINICAL IMMUNOLOGY PLLC
Entity Type:Organization
Organization Name:ALLERGY & CLINICAL IMMUNOLOGY PLLC
Other - Org Name:ALLLERGIC DIAGNOSTIC & TREATMENT CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PFLANZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-558-8426
Mailing Address - Street 1:2801 BOLTON BOONE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2041
Mailing Address - Country:US
Mailing Address - Phone:972-298-6677
Mailing Address - Fax:972-298-5583
Practice Address - Street 1:2801 BOLTON BOONE DR STE 101
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2041
Practice Address - Country:US
Practice Address - Phone:972-298-6677
Practice Address - Fax:972-298-5583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-28
Last Update Date:2023-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty