Provider Demographics
NPI:1023469178
Name:NORTH AUSTIN ALLERGY AND WELLNESS LLC
Entity type:Organization
Organization Name:NORTH AUSTIN ALLERGY AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-215-8985
Mailing Address - Street 1:3705 MEDICAL PKWY
Mailing Address - Street 2:UNIT 440
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1019
Mailing Address - Country:US
Mailing Address - Phone:512-215-8985
Mailing Address - Fax:512-215-8517
Practice Address - Street 1:3705 MEDICAL PKWY
Practice Address - Street 2:UNIT 440
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1019
Practice Address - Country:US
Practice Address - Phone:512-215-8985
Practice Address - Fax:512-215-8517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-29
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty