Provider Demographics
NPI:1316024854
Name:TEXAS SPECIALTY CARE FOR ALLERGY AND ASTHMA, P.A.
Entity Type:Organization
Organization Name:TEXAS SPECIALTY CARE FOR ALLERGY AND ASTHMA, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THANAI
Authorized Official - Middle Name:
Authorized Official - Last Name:PONGDEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-661-9197
Mailing Address - Street 1:10 MEDICAL PKWY
Mailing Address - Street 2:PLAZA 3, SUITE 202
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7840
Mailing Address - Country:US
Mailing Address - Phone:972-661-9197
Mailing Address - Fax:972-692-7153
Practice Address - Street 1:10 MEDICAL PKWY
Practice Address - Street 2:PLAZA 3, SUITE 202
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7840
Practice Address - Country:US
Practice Address - Phone:972-661-9197
Practice Address - Fax:972-692-7153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6579207K00000X, 207KA0200X, 207RA0201X, 2080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & ImmunologyGroup - Single Specialty
No2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/ImmunologyGroup - Single Specialty