Provider Demographics
NPI:1598825408
Name:ALLERGY & ASTHMA CENTER AT NORTHPARK
Entity type:Organization
Organization Name:ALLERGY & ASTHMA CENTER AT NORTHPARK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOT
Authorized Official - Middle Name:
Authorized Official - Last Name:LAURIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-923-7611
Mailing Address - Street 1:2460 N I35 EAST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-5266
Mailing Address - Country:US
Mailing Address - Phone:972-923-9200
Mailing Address - Fax:972-923-9201
Practice Address - Street 1:2460 N I35 EAST
Practice Address - Street 2:SUITE 220
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-5266
Practice Address - Country:US
Practice Address - Phone:972-923-9200
Practice Address - Fax:972-923-9201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2947207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty