MEDICARE: ALLERGY, ASTHMA AND IMMUNOLOGY SPECIALISTS OF SAN ANTONIO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207K00000X	Allergy & Immunology Physician

General Provider Information

NPI Number	:	1073177440
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLERGY, ASTHMA AND IMMUNOLOGY SPECIALISTS OF SAN ANTONIO

Provider Business Mailing Address
First Line	:	21727 IH 10 W STE 104
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78257-2108
Country	:	US
Telephone Number	:	210-899-6856
Fax Number	:	210-750-3056

Provider Business Practice Location Address
First Line	:	21727 IH 10 W STE 104
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78257-2108
Country	:	US
Telephone Number	:	210-899-6856
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ARACELI ELIZALDE
Credential	:	MD
Telephone Number	:	210-899-6856

Provider Enumeration Date	:	04/30/2019
Last Update Date	:	09/20/2025

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