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General NPI Number Information
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NPI Number | 1497762629
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Entity Type | Individual
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Provider Name | ANGELA E ASOM MD
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Gender | Female
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 12/08/2023
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Provider Practice Location Address
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Address Line | 717 S GREENVILLE AVE STE 104
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City | ALLEN
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State | TX
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Zip | 75002-3317
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Country | US
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Telephone | 972-396-1900
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Fax | 972-396-1901
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Provider Business Mailing Address
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Address Line | 421 PALOMINO WAY
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City | FAIRVIEW
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State | TX
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Zip | 75069-1531
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Country | US
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Telephone | 469-585-7721
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD2023-1277
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MA69683
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD058635L
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | L8604
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License Number State | TX
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