Organization
DENTON 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
3105 COLORADO BLVD, SUITE 101, DENTON, TX 76210
(972) 398-3500
(972) 398-3512
Mailing address
6101 WINDCOM COURT, STE 400, PLANO, TX 75093-7817
(972) 398-3500
(972) 398-3512
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
—
Other
Enumeration date
10/21/2010
Last updated
10/21/2010
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