MEDICARE: EAST TEXAS ALLERGY & ASTHMA ASSOCIATES

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	174400000X	Specialist	F9577	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871711267
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST TEXAS ALLERGY & ASTHMA ASSOCIATES

Provider Business Mailing Address
First Line	:	1009 N 4TH ST STE A
Second Line	:
City	:	LONGVIEW
State	:	TX
Zip	:	75601-4768
Country	:	US
Telephone Number	:	903-757-3808
Fax Number	:	903-757-3893

Provider Business Practice Location Address
First Line	:	1009 N 4TH ST STE A
Second Line	:
City	:	LONGVIEW
State	:	TX
Zip	:	75601-4768
Country	:	US
Telephone Number	:	903-757-3808
Fax Number	:	903-757-3893

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TODD READ HOLMAN
Credential	:	M.D.
Telephone Number	:	903-757-3808

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	08/07/2008

Similar Medicare Providers

1982607776 — TODD READ HOLMAN M.D.
Practice Location Address:

1009 N 4TH ST , STE A
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75601-4768

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1891716510 — ERIC CHEN M.D.
Practice Location Address:

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1881790913 — EMILY D WILLIAMS PA
Practice Location Address:

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1316170160 — AMANDA J PRINCE CHEN CPNP
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1962728642 — DR. JUSTIN RAY CHEN M.D.
Practice Location Address:

1009 N 4TH ST STE A
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Directions to “EAST TEXAS ALLERGY & ASTHMA ASSOCIATES ” Practice Location

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