Provider Demographics
NPI:1730290099
Name:FAAC, P.A.
Entity Type:Organization
Organization Name:FAAC, P.A.
Other - Org Name:FAMILY ALLERGY AND ASTHMA CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-539-0086
Mailing Address - Street 1:3051 CHURCHILL DR
Mailing Address - Street 2:STE 130
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-2713
Mailing Address - Country:US
Mailing Address - Phone:972-539-0086
Mailing Address - Fax:972-355-9680
Practice Address - Street 1:3051 CHURCHILL DR STE 130
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-2710
Practice Address - Country:US
Practice Address - Phone:972-539-0086
Practice Address - Fax:972-355-9680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4184207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX82393SOtherBC/BS
TX5827034OtherAETNA
TX82390SOtherBC/BS
TX82391SOtherBC/BS
TX4378428OtherAETNA
TXE04425Medicare UPIN
TX83261KMedicare ID - Type Unspecified
TXG13326Medicare UPIN
TX5827034OtherAETNA