Provider Demographics
NPI:1861059016
Name:ALLERGY & ENT ASSOCIATES, PLLC
Entity type:Organization
Organization Name:ALLERGY & ENT ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:SHAKARI
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-453-4213
Mailing Address - Street 1:450 GEARS RD STE 420
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77067-4529
Mailing Address - Country:US
Mailing Address - Phone:281-453-4211
Mailing Address - Fax:
Practice Address - Street 1:107 OLD RIVER RD STE D
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77356-2852
Practice Address - Country:US
Practice Address - Phone:936-582-6001
Practice Address - Fax:936-582-7001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-23
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty