Provider Demographics
NPI:1073177440
Name:ALLERGY, ASTHMA AND IMMUNOLOGY SPECIALISTS OF SAN ANTONIO
Entity Type:Organization
Organization Name:ALLERGY, ASTHMA AND IMMUNOLOGY SPECIALISTS OF SAN ANTONIO
Other - Org Name:ALLERGY AND ASTHMA TEXAS HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARACELI
Authorized Official - Middle Name:
Authorized Official - Last Name:ELIZALDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-899-6856
Mailing Address - Street 1:21727 IH 10 W STE 104
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257-2108
Mailing Address - Country:US
Mailing Address - Phone:210-899-6856
Mailing Address - Fax:210-750-3056
Practice Address - Street 1:21727 IH 10 W
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257-2106
Practice Address - Country:US
Practice Address - Phone:210-899-6856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-30
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty