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General NPI Number Information
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NPI Number | 1134926561
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Entity Type | Organization
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Legal Business Name | ALLERGY & ASTHMA CARE OF WYLIE, PLLC
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Dates
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Enumeration Date | 02/25/2025
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 611 S HIGHWAY 78 STE 102
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City | WYLIE
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State | TX
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Zip | 75098-4085
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Country | US
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Telephone | 972-954-9826
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Fax |
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Provider Business Mailing Address
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Address Line | 611 S HIGHWAY 78 STE 102
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City | WYLIE
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State | TX
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Zip | 75098-4085
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Country | US
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Telephone | 972-954-9826
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | ANGELA FADAHUNSI
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Credential | MD
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Telephone | 972-954-9826
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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