Provider Demographics
NPI:1710222039
Name:CHEST, ALLERGY AND SLEEP CLINIC PLLC
Entity Type:Organization
Organization Name:CHEST, ALLERGY AND SLEEP CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:N
Authorized Official - Last Name:ALFARAWATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD,FCCP
Authorized Official - Phone:972-884-4160
Mailing Address - Street 1:3413 SPECTRUM BLVD
Mailing Address - Street 2:# 100
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-9705
Mailing Address - Country:US
Mailing Address - Phone:972-884-4160
Mailing Address - Fax:972-668-1618
Practice Address - Street 1:3413 SPECTRUM BLVD
Practice Address - Street 2:# 100
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-9705
Practice Address - Country:US
Practice Address - Phone:972-884-4160
Practice Address - Fax:972-668-1618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-28
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP1724174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty