Organization
LONE STAR ALLERGY, ASTHMA, AND IMMUNOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MUDITA KIRIT SHAH M.D. (MANAGER)
(817) 810-9800
Entity
Organization
Contact information
Practice address
800 8TH AVE, SUITE 323, FORT WORTH, TX 76104-2601
(817) 810-9800
(817) 840-6403
Mailing address
800 8TH AVE, SUITE 324, FORT WORTH, TX 76104-2601
(817) 810-9800
(817) 840-6403
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
N2791
TX
Other
Enumeration date
10/18/2010
Last updated
02/28/2012
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