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General NPI Number Information
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NPI Number | 1023469178
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Entity Type | Organization
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Legal Business Name | NORTH AUSTIN ALLERGY AND WELLNESS LLC
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Dates
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Enumeration Date | 06/29/2016
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Last Update Date | 06/29/2016
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Provider Practice Location Address
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Address Line | 3705 MEDICAL PKWY UNIT 440
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City | AUSTIN
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State | TX
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Zip | 78705-1019
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Country | US
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Telephone | 512-215-8985
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Fax | 512-215-8517
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Provider Business Mailing Address
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Address Line | 3705 MEDICAL PKWY UNIT 440
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City | AUSTIN
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State | TX
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Zip | 78705-1019
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Country | US
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Telephone | 512-215-8985
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Fax | 512-215-8517
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Authorized Official
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Title or Position | OWNER
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Name | JOHN NELSON
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Credential |
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Telephone | 512-215-8985
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number |
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License Number State |
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