| Allergy & Clinical Immunology Pllc | |
|
2801 Bolton Boone Dr Ste 101 Desoto TX 75115-2041 | |
| (972) 298-6677 | |
| (972) 298-5583 |
| Full Name | Allergy & Clinical Immunology Pllc |
|---|---|
| Speciality | Allergy & Immunology |
| Location | 2801 Bolton Boone Dr Ste 101, Desoto, Texas |
| Authorized Official Name and Position | Jia Pflanzer (OFFICE MANAGER) |
| Authorized Official Contact | 2145588426 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Allergy & Clinical Immunology Pllc 2801 Bolton Boone Dr Ste 101 Desoto TX 75115-2041 Ph: (972) 298-6677 | Allergy & Clinical Immunology Pllc 2801 Bolton Boone Dr Ste 101 Desoto TX 75115-2041 Ph: (972) 298-6677 |
| NPI Number | 1033833629 |
|---|---|
| Provider Enumeration Date | 09/28/2022 |
| Last Update Date | 05/21/2023 |
| Medicare PECOS PAC ID | 6305375320 |
|---|---|
| Medicare Enrollment ID | O20250121001942 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033833629 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 207KA0200X | Allergy & Immunology - Allergy | (* (Not Available)) | Primary |
| Provider Name | Rafiquddin S Rahimi |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1386713329 PECOS PAC ID: 3476573122 Enrollment ID: I20100608000109 |
| Provider Name | Joseph Pflanzer |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1336139377 PECOS PAC ID: 8426189317 Enrollment ID: I20100621000479 |
| Provider Name | Selena M Frazier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659139384 PECOS PAC ID: 3476095944 Enrollment ID: I20240612001136 |
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