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General NPI Number Information
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NPI Number | 1609155050
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Entity Type | Organization
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Legal Business Name | SUMMIT ALLERGY LABS, LLC
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Dates
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Enumeration Date | 08/16/2011
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Last Update Date | 08/16/2011
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Provider Practice Location Address
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Address Line | 4141 SOUTHWEST FWY SUITE 410
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City | HOUSTON
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State | TX
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Zip | 77027-7313
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Country | US
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Telephone | 713-255-1211
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Fax |
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Provider Business Mailing Address
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Address Line | 4141 SOUTHWEST FWY SUITE 410
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City | HOUSTON
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State | TX
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Zip | 77027-7313
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Country | US
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Telephone | 713-255-1211
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Fax |
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Authorized Official
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Title or Position | OWNER / MEMBER
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Name | DR. BRYAN HASSE
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Credential | DC, FNP, RN,
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Telephone | 713-255-1211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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