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General NPI Number Information
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NPI Number | 1316024854
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Entity Type | Organization
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Legal Business Name | TEXAS SPECIALTY CARE FOR ALLERGY AND ASTHMA, P.A.
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 11/10/2008
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Provider Practice Location Address
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Address Line | 10 MEDICAL PKWY PLAZA 3, SUITE 202
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City | DALLAS
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State | TX
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Zip | 75234-7840
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Country | US
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Telephone | 972-661-9197
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Fax | 972-692-7153
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Provider Business Mailing Address
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Address Line | 10 MEDICAL PKWY PLAZA 3, SUITE 202
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City | DALLAS
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State | TX
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Zip | 75234-7840
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Country | US
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Telephone | 972-661-9197
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Fax | 972-692-7153
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Authorized Official
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Title or Position | PRESIDENT
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Name | THANAI PONGDEE
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Credential | M.D.
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Telephone | 972-661-9197
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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 | L6579
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RA0201X
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Taxonomy Name | Allergy & Immunology (Internal Medicine) Physician
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License Number | L6579
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2080P0201X
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Taxonomy Name | Pediatric Allergy/Immunology Physician
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License Number | L6579
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | L6579
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License Number State | TX
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