Provider Demographics
NPI:1568545739
Name:TEXAS REGIONAL ASTHMA & ALLERGY CENTER
Entity Type:Organization
Organization Name:TEXAS REGIONAL ASTHMA & ALLERGY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:RENE
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:LEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-421-0770
Mailing Address - Street 1:900 E SOUTHLAKE BLVD
Mailing Address - Street 2:STE 300
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6375
Mailing Address - Country:US
Mailing Address - Phone:817-421-0770
Mailing Address - Fax:817-421-4759
Practice Address - Street 1:900 E SOUTHLAKE BLVD
Practice Address - Street 2:STE 300
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6375
Practice Address - Country:US
Practice Address - Phone:817-421-0770
Practice Address - Fax:817-421-4759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty