MEDICARE: BEACON HEALTH-ALLERGY, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207K00000X	Allergy & Immunology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821375551
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEACON HEALTH-ALLERGY, LLC

Provider Business Mailing Address
First Line	:	800 TOWN AND COUNTRY BLVD
Second Line	:	SUITE 300
City	:	HOUSTON
State	:	TX
Zip	:	77024-4552
Country	:	US
Telephone Number	:	210-365-0975
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 TOWN AND COUNTRY BLVD
Second Line	:	SUITE 300
City	:	HOUSTON
State	:	TX
Zip	:	77024-4552
Country	:	US
Telephone Number	:	210-365-0975
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	RON BARSHOP
Credential	:
Telephone Number	:	210-365-0975

Provider Enumeration Date	:	11/09/2011
Last Update Date	:	01/28/2014

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Directions to “BEACON HEALTH-ALLERGY, LLC ” Practice Location

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