Provider Demographics
NPI:1699141143
Name:ALLERGY, ASTHMA AND IMMUNOLOGY SPECIALTY CENTER OF TEXAS, PA
Entity type:Organization
Organization Name:ALLERGY, ASTHMA AND IMMUNOLOGY SPECIALTY CENTER OF TEXAS, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BONDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-332-6090
Mailing Address - Street 1:1101 W MAIN ST
Mailing Address - Street 2:SUITE P
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-2046
Mailing Address - Country:US
Mailing Address - Phone:281-332-6090
Mailing Address - Fax:832-932-5034
Practice Address - Street 1:1101 W MAIN ST
Practice Address - Street 2:SUITE P
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-2046
Practice Address - Country:US
Practice Address - Phone:281-332-6090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-19
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6842207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty