Provider Demographics
NPI:1124280599
Name:LUNG AND ASTHMA CLINIC, P.A.
Entity type:Organization
Organization Name:LUNG AND ASTHMA CLINIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GHASSAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:NOUREDDINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-795-5155
Mailing Address - Street 1:6550 FANNIN ST STE 2421
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2748
Mailing Address - Country:US
Mailing Address - Phone:713-795-5155
Mailing Address - Fax:713-795-5515
Practice Address - Street 1:2327 E HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-3835
Practice Address - Country:US
Practice Address - Phone:979-864-3329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-27
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9248207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00X580Medicare PIN
TXF41424Medicare UPIN