Provider Demographics
NPI:1841389426
Name:STEPHEN MARK OLMSTEAD, D.O., ALLERGY, ASTHMA & IMMUNOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:STEPHEN MARK OLMSTEAD, D.O., ALLERGY, ASTHMA & IMMUNOLOGY ASSOCIATES
Other - Org Name:ALLERGY, ASTHMA & IMMUNOLOGY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:OLMSTEAD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:972-463-3406
Mailing Address - Street 1:7150 N PRESIDENT GEORGE BUSH HWY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-2208
Mailing Address - Country:US
Mailing Address - Phone:972-463-3406
Mailing Address - Fax:972-412-6317
Practice Address - Street 1:7150 N PRESIDENT GEORGE BUSH HWY
Practice Address - Street 2:SUITE 204
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-2208
Practice Address - Country:US
Practice Address - Phone:972-463-3406
Practice Address - Fax:972-412-6317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8336174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE92000Medicare UPIN