Provider Demographics
NPI:1730377284
Name:ALLERGY & ASTHMA CENTER OF GEORGETOWN, P.A.
Entity type:Organization
Organization Name:ALLERGY & ASTHMA CENTER OF GEORGETOWN, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:M
Authorized Official - Last Name:AMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-868-6673
Mailing Address - Street 1:3201 SOUTH AUSTIN AVENUE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-7554
Mailing Address - Country:US
Mailing Address - Phone:512-868-6673
Mailing Address - Fax:512-819-0021
Practice Address - Street 1:3201 SOUTH AUSTIN AVENUE
Practice Address - Street 2:SUITE 140
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-7554
Practice Address - Country:US
Practice Address - Phone:512-868-6673
Practice Address - Fax:512-819-0021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-10
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00151KMedicare PIN
TXF77545Medicare UPIN