| Lone Star Allergy, Asthma, And Immunology | |
|
800 8th Ave Suite 323 Fort Worth TX 76104-2601 | |
| (817) 810-9800 | |
| (817) 840-6403 |
| Full Name | Lone Star Allergy, Asthma, And Immunology |
|---|---|
| Speciality | Clinic/Center |
| Location | 800 8th Ave, Fort Worth, Texas |
| Authorized Official Name and Position | Mudita Kirit Shah (MANAGER) |
| Authorized Official Contact | 8178109800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lone Star Allergy, Asthma, And Immunology 800 8th Ave Suite 324 Fort Worth TX 76104-2601 Ph: (817) 810-9800 | Lone Star Allergy, Asthma, And Immunology 800 8th Ave Suite 323 Fort Worth TX 76104-2601 Ph: (817) 810-9800 |
| NPI Number | 1992015465 |
|---|---|
| Provider Enumeration Date | 10/18/2010 |
| Last Update Date | 02/28/2012 |
| Medicare PECOS PAC ID | 2264615947 |
|---|---|
| Medicare Enrollment ID | O20110318000390 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992015465 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | N2791 (Texas) | Primary |
| Provider Name | Mudita K Shah |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1649492679 PECOS PAC ID: 7517140197 Enrollment ID: I20110318000422 |
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