Provider Demographics
NPI:1477860823
Name:ADVANCED ALLERGY, ASTHMA, & IMMUNOLOGY CENTER, P.A.
Entity Type:Organization
Organization Name:ADVANCED ALLERGY, ASTHMA, & IMMUNOLOGY CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:LYNETTE GOMEZ
Authorized Official - Last Name:DINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:210-499-4824
Mailing Address - Street 1:540 MADISON OAK DR
Mailing Address - Street 2:SUITE #210
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3943
Mailing Address - Country:US
Mailing Address - Phone:210-499-4824
Mailing Address - Fax:210-499-4825
Practice Address - Street 1:540 MADISON OAK DR
Practice Address - Street 2:SUITE #210
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3943
Practice Address - Country:US
Practice Address - Phone:210-499-4824
Practice Address - Fax:210-499-4825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-07
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9178261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty