Provider Demographics
NPI:1326272782
Name:ALLERGY & ASTHMA CENTER, INC.
Entity Type:Organization
Organization Name:ALLERGY & ASTHMA CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:TAUSCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-255-1512
Mailing Address - Street 1:1224 PENNSYLVANIA ST NE STE B
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-7442
Mailing Address - Country:US
Mailing Address - Phone:505-255-1512
Mailing Address - Fax:505-255-1513
Practice Address - Street 1:1224 PENNSYLVANIA ST NE STE B
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-7442
Practice Address - Country:US
Practice Address - Phone:505-255-1512
Practice Address - Fax:505-255-1513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM20070747207K00000X
NM2007-0747207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNMB2121Medicare PIN