Provider Demographics
NPI:1295813301
Name:ALLERGY CLINIC LLP
Entity type:Organization
Organization Name:ALLERGY CLINIC LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:CMIS
Authorized Official - Phone:281-991-6750
Mailing Address - Street 1:6243 FAIRMONT PKWY STE 102
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-4046
Mailing Address - Country:US
Mailing Address - Phone:281-991-6750
Mailing Address - Fax:281-991-7611
Practice Address - Street 1:6243 FAIRMONT PKWY STE 102
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-4046
Practice Address - Country:US
Practice Address - Phone:281-991-6750
Practice Address - Fax:281-991-7611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0802902-01Medicaid
TX0027BYMedicare UPIN
TX0802902-01Medicaid