Healthcare Provider Details

I. General information

NPI: 1396723896
Provider Name (Legal Business Name): LUNG AND ASTHMA CLINIC, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 06/15/2022
Certification Date: 06/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6550 FANNIN ST STE 2123
HOUSTON TX
77030-2709
US

IV. Provider business mailing address

PO BOX 973722
DALLAS TX
75397-3722
US

V. Phone/Fax

Practice location:
  • Phone: 713-795-5155
  • Fax: 713-795-5515
Mailing address:
  • Phone: 713-795-5155
  • Fax: 713-795-5515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: GHASSAN NOUREDDINE
Title or Position: OWNER
Credential: M.D.
Phone: 713-795-5155