MEDICARE: LUNG AND ASTHMA CLINIC, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207RP1001X	Pulmonary Disease Physician
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician

General Provider Information

NPI Number	:	1396723896
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUNG AND ASTHMA CLINIC, P.A.

Provider Business Mailing Address
First Line	:	PO BOX 973722
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75397-3722
Country	:	US
Telephone Number	:	713-795-5155
Fax Number	:	713-795-5515

Provider Business Practice Location Address
First Line	:	6550 FANNIN ST STE 2123
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2709
Country	:	US
Telephone Number	:	713-795-5155
Fax Number	:	713-795-5515

Authorized Official
Title or Position	:	OWNER
Name	:	GHASSAN NOUREDDINE
Credential	:	M.D.
Telephone Number	:	713-795-5155

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	06/15/2022

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