Healthcare Provider Details
I. General information
NPI: 1972056034
Provider Name (Legal Business Name): ASTHMA & ALLERGY ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/25/2016
Last Update Date: 05/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7608 N UNION BLVD SUITE D
COLORADO SPRINGS CO
80920-3886
US
IV. Provider business mailing address
2709 N TEJON ST
COLORADO SPRINGS CO
80907-6231
US
V. Phone/Fax
- Phone: 719-476-0420
- Fax:
- Phone: 719-476-0420
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RA0201X |
| Taxonomy | Allergy & Immunology (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
PAUL
BYER
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 719-473-0872