Healthcare Provider Details

I. General information

NPI: 1801864574
Provider Name (Legal Business Name): ALLERGY, ASTHMA & IMMUNOLOGY ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 10/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3939 HOUMA BLVD SUITE 20
METAIRIE LA
70006-2931
US

IV. Provider business mailing address

3939 HOUMA BLVD SUITE 20
METAIRIE LA
70006-2931
US

V. Phone/Fax

Practice location:
  • Phone: 504-885-2121
  • Fax: 504-885-2141
Mailing address:
  • Phone: 504-885-2121
  • Fax: 504-885-2141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CAROLYN BEACH DAUL
Title or Position: OWNER
Credential: M.D., PH.D.
Phone: 504-885-2121