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General NPI Number Information
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NPI Number | 1881201754
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Entity Type | Organization
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Legal Business Name | WILLIAM STORMS ALLERGY CLINIC PC
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Dates
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Enumeration Date | 09/25/2020
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Last Update Date | 09/25/2020
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Provider Practice Location Address
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Address Line | 900 INDIANA AVE STE C
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City | PUEBLO
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State | CO
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Zip | 81004-3767
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Country | US
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Telephone | 719-955-6000
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Fax | 855-828-0878
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Provider Business Mailing Address
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Address Line | 5929 BALCONES DR STE 200
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City | AUSTIN
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State | TX
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Zip | 78731-4280
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Country | US
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Telephone | 125-501-8005
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Fax | 855-828-0878
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Authorized Official
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Title or Position | CREDENTIALS SPECIALIST
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Name | LINDA SCHUTT
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Credential |
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Telephone | 512-548-0988
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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 |
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License Number State |
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