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General NPI Number Information
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NPI Number | 1124125117
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Entity Type | Organization
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Legal Business Name | ALLERGY & ASTHMA CENTER PA
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 05/30/2008
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Provider Practice Location Address
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Address Line | 333 LONDONDERRY DR SUITE # 100
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City | WACO
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State | TX
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Zip | 76712-7900
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Country | US
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Telephone | 254-751-1144
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Fax | 254-751-1185
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Provider Business Mailing Address
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Address Line | 333 LONDONDERRY DR SUITE # 100
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City | WACO
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State | TX
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Zip | 76712-7900
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Country | US
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Telephone | 254-751-1144
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Fax | 254-751-1185
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NIRAN JAN AMAR II
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Credential | M.D.
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Telephone | 254-751-1144
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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 | G2305
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License Number State | TX
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