Provider Demographics
NPI:1437401429
Name:ALLERGY & ASTHMA CENTER OF EL PASO, PA
Entity type:Organization
Organization Name:ALLERGY & ASTHMA CENTER OF EL PASO, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP MANAGED CARE
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-665-7122
Mailing Address - Street 1:4501 N. MESA
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912
Mailing Address - Country:US
Mailing Address - Phone:915-584-7474
Mailing Address - Fax:915-833-6327
Practice Address - Street 1:4501 N. MESA
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912
Practice Address - Country:US
Practice Address - Phone:915-584-7474
Practice Address - Fax:915-833-6327
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BREATHEAMERICA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-15
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty