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General NPI Number Information
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NPI Number | 1730745605
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Entity Type | Organization
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Legal Business Name | MAGNOLIA ALLERGY AND ASTHMA GROUP, PLLC
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Dates
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Enumeration Date | 05/15/2019
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Last Update Date | 03/31/2020
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Provider Practice Location Address
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Address Line | 3801 GASTON AVE STE 318
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City | DALLAS
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State | TX
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Zip | 75246-1500
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Country | US
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Telephone | 440-503-0805
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Fax |
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Provider Business Mailing Address
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Address Line | 3801 GASTON AVE STE 318
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City | DALLAS
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State | TX
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Zip | 75246-1500
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Country | US
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Telephone | 469-372-0274
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Fax | 469-372-0276
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MONICA SANDHU
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Credential | DO
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Telephone | 469-372-0274
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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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