Healthcare Provider Details

I. General information

NPI: 1366321952
Provider Name (Legal Business Name): ASTHMA & ALLERGY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2025
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 PLUMTREE RD STE B
BEL AIR MD
21015-6056
US

IV. Provider business mailing address

2500 LEGACY DR STE 200
FRISCO TX
75034-1844
US

V. Phone/Fax

Practice location:
  • Phone: 410-638-1999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: TAYLOR KNUTSON
Title or Position: CHIEF OF STAFF
Credential:
Phone: 361-244-3468