Provider Demographics
NPI:1851586994
Name:PARK LANE ALLERGY AND ASTHMA CENTER, PA
Entity Type:Organization
Organization Name:PARK LANE ALLERGY AND ASTHMA CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:214-363-8889
Mailing Address - Street 1:9101 N CENTRAL EXPY
Mailing Address - Street 2:430
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-5927
Mailing Address - Country:US
Mailing Address - Phone:214-363-8889
Mailing Address - Fax:214-363-9416
Practice Address - Street 1:9101 N CENTRAL EXPY
Practice Address - Street 2:430
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5927
Practice Address - Country:US
Practice Address - Phone:214-363-8889
Practice Address - Fax:214-363-9416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4312261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center