Provider Demographics
NPI:1043347107
Name:ADULT & PEDIATRIC ASTHMA & ALLERGY CENTER, P.C.
Entity Type:Organization
Organization Name:ADULT & PEDIATRIC ASTHMA & ALLERGY CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALMA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:251-633-3311
Mailing Address - Street 1:1032 HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-3917
Mailing Address - Country:US
Mailing Address - Phone:251-633-3311
Mailing Address - Fax:251-633-3004
Practice Address - Street 1:1032 HILLCREST RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-3917
Practice Address - Country:US
Practice Address - Phone:251-633-3311
Practice Address - Fax:251-633-3004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14501207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529100010Medicaid
AL82586Medicare ID - Type Unspecified
AL529100010Medicaid