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General NPI Number Information
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NPI Number | 1164680781
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Entity Type | Organization
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Legal Business Name | COBB ALLERGY CLINIC OF SAN MARCOS
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Dates
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Enumeration Date | 05/30/2008
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Last Update Date | 05/30/2008
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Provider Practice Location Address
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Address Line | 101 CENTER POINT RD
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City | SAN MARCOS
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State | TX
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Zip | 78666-6425
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Country | US
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Telephone | 512-396-2125
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Fax | 512-396-2126
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Provider Business Mailing Address
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Address Line | PO BOX 913
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City | SAN MARCOS
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State | TX
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Zip | 78667-0913
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Country | US
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Telephone | 512-396-2125
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Fax | 512-396-2126
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALBERT HARRON COBB JR.
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Credential | M.D.
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Telephone | 512-396-2125
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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 | D9399
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License Number State | TX
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