Healthcare Provider Details
I. General information
NPI: 1821758525
Provider Name (Legal Business Name): US ALLERGY & ASTHMA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/21/2021
Last Update Date: 04/09/2023
Certification Date: 04/09/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11500 STATE HIGHWAY 121 STE 910
FRISCO TX
75035-9347
US
IV. Provider business mailing address
11500 STATE HIGHWAY 121 STE 910
FRISCO TX
75035-9347
US
V. Phone/Fax
- Phone: 469-200-2605
- Fax: 469-200-2606
- Phone: 469-200-2605
- Fax: 469-200-2605
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RA0201X |
| Taxonomy | Allergy & Immunology (Internal Medicine) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NAVEEN
SIKKA
Title or Position: OWNER
Credential: MD
Phone: 469-200-2605