Provider Demographics
NPI:1235905688
Name:ALLERGY & ENT ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:ALLERGY & ENT ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:SHAKARI
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-453-4213
Mailing Address - Street 1:PO BOX 122338
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75312-2338
Mailing Address - Country:US
Mailing Address - Phone:281-875-8428
Mailing Address - Fax:
Practice Address - Street 1:26750 FM 1093 RD STE 170
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-2786
Practice Address - Country:US
Practice Address - Phone:281-875-8428
Practice Address - Fax:281-874-0212
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLERGY & ENT ASSOCIATES, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty