Organization Active NPI

Allergy & Asthma Care of Waco, PA

  • Specialist
  • Waco, TX
National Provider Identifier
1487847463
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G1639 Issued in TX
Legal business name
ALLERGY & ASTHMA CARE OF WACO, PA
Practice address
221 Jewell Dr
Waco, TX 76712-6630
Phone
(254) 753-3646
Fax
(254) 753-1411
NPI assigned
Aug 22, 2007
Last updated
Jul 28, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Pramila K. Daftary, M.D.NPI 1255399945
Title
President
Phone
(254) 753-3646

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X G1639 TX Primary

Addresses

Primary practice location

221 Jewell Dr
Waco, TX 76712-6630

Mailing address

221 Jewell Dr
Waco, TX 76712-6630
Phone (254) 753-3646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090617000392 TX Part B Supplier - Clinic/Group Practice 9335299130 Receives reassigned benefits from 3 practitioners
Practice locations: Waco, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1078060Allergy & Asthma Care of Waco221 Jewell Drive, Waco, TX 76712Certificate of waiverDec 27, 2027

National Provider Directory

National Provider Directory

Locations

221 Jewell Dr
Waco, TX 76712
Phone (254) 753-3646

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627430400000",
    "number": "1487847463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 JEWELL DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767126630",
            "telephone_number": "254-753-3646",
            "fax_number": "254-753-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 JEWELL DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767126630",
            "telephone_number": "254-753-3646",
            "fax_number": "254-753-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLERGY & ASTHMA CARE OF WACO, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-22",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A",
        "authorized_official_last_name": "DAFTARY",
        "authorized_official_first_name": "PRAMILA",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "254-753-3646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "G1639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.