Provider Demographics
NPI:1750610630
Name:ALLERGY EAR, NOSE & THROAT CLINIC OF NE TEXAS
Entity type:Organization
Organization Name:ALLERGY EAR, NOSE & THROAT CLINIC OF NE TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:J
Authorized Official - Last Name:DAWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-772-4200
Mailing Address - Street 1:4521 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069
Mailing Address - Country:US
Mailing Address - Phone:972-548-7555
Mailing Address - Fax:972-542-8561
Practice Address - Street 1:4521 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 400
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069
Practice Address - Country:US
Practice Address - Phone:972-548-7555
Practice Address - Fax:972-542-8561
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLERGY EAR, NOSE & THROAT CLINIC OF NE TEXAS, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-23
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80175231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty