=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033139498
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SOUTHWEST ASTHMA & ALLERGY ASSOCIATES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/20/2006
-----------------------------------------------------
Last Update Date | 02/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 902 FROSTWOOD DR STE 302
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77024-2428
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-973-0051
-----------------------------------------------------
Fax | 713-973-7130
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 902 FROSTWOOD DR STE 302
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77024-2428
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-596-8526
-----------------------------------------------------
Fax | 713-596-8560
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MR. MIKE SANDERS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 713-596-8500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207K00000X
-----------------------------------------------------
Taxonomy Name | Allergy & Immunology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------