Organization
PEDIATRIC ALLERGY IMMUNOLOGY ASSOC.,P.A.
Active
Other names
Dallas Allergy Immunology
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD L WASSERMAN M.D., PHD (PRESIDENT)
(972) 566-7788
Entity
Organization
Contact information
Practice address
7777 FOREST LANE, SB332, DALLAS, TX 75230-6822
(972) 566-7788
(972) 566-8837
Mailing address
7777 FOREST LN, SUITE B332, DALLAS, TX 75230-2571
(972) 566-7788
(972) 566-8837
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0851610-02
—
TX
05
—
200032360A
—
OK
Enumeration date
05/24/2005
Last updated
06/27/2013
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