Organization
TEXOMA ALLERGY GROUP, PLLC
Active
Other names
Southwest Allergy& Asthma Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN A, VAN WAGONER PA MD (OWNER/PRESIDENT)
(972) 398-3500
Entity
Organization
Contact information
Practice address
5012 SOUTH US HIGHWAY 75, SUITE 150, DENISON, TX 75020
(972) 398-3500
(972) 398-3572
Mailing address
6101 WINDCOM COURT, STE 400, PLANO, TX 75093-7817
(972) 398-3500
(972) 398-3512
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/07/2010
Last updated
10/07/2010
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