John Allen Van Wagoner M.D. P.A.
Allergy & Immunology in Denton, TX. Organization (NPI-2).
NPI number1649592205
StatusActive
Last updated in NPPESFeb 24, 2010
Details
- NPI
- 1649592205
- Entity type
- Organization (NPI-2)
- Legal business name
- John Allen Van Wagoner M.D. P.A.
- Organization subpart
- No
- Enumeration date
- Feb 24, 2010
- Last updated
- Feb 24, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207K00000X | Allergy & Immunology | K8854 | TX | Yes |
Other names
- Southwest Allergy & Asthma Center (Doing Business As)
Practice location
3105 Colorado Blvd.Ste 150
Denton, TX 76210
Phone 972-398-3500 · Fax 972-398-3512
Mailing address
6101 Windcom CourtSte 400
Plano, TX 75093-7817
Phone 972-398-3500 · Fax 972-398-3512
Authorized official
John A. Van Wagoner
Owner/President
9723983500
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