Provider Demographics
NPI:1174642037
Name:ALLERVIE HEALTH TEXAS, P.A.
Entity Type:Organization
Organization Name:ALLERVIE HEALTH TEXAS, P.A.
Other - Org Name:ALLERGY AND ASTHMA CLINIC OF WEST TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RCM BUSINESS PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LILY
Authorized Official - Middle Name:
Authorized Official - Last Name:FLYNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-209-8355
Mailing Address - Street 1:3502 22ND ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1308
Mailing Address - Country:US
Mailing Address - Phone:806-799-4192
Mailing Address - Fax:806-799-6299
Practice Address - Street 1:3502 22ND ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1308
Practice Address - Country:US
Practice Address - Phone:806-799-4192
Practice Address - Fax:806-799-6299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207K00000X, 207K00000X
TXH2237207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0082EBOtherBCBS PROVIDER NUMBER
1861597973OtherNPI NUMBER
TX034074701Medicaid
TX0082EBOtherBCBS PROVIDER NUMBER
TX040015473Medicare ID - Type UnspecifiedRAILROAD PROVIDER NUMBER
TX034074701Medicaid