Organization Active NPI

Allergy and Asthma Clinic of Central Texas, PA

  • Allergy & Immunology Physician
  • Round Rock, TX
National Provider Identifier
1831294800
Registry record updated Mar 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
F4284 Issued in TX
Legal business name
ALLERGY AND ASTHMA CLINIC OF CENTRAL TEXAS, PA
Practice address
2000 N Mays St Ste 109
Round Rock, TX 78664-2166
Phone
(254) 690-2800
Fax
(254) 690-5401
NPI assigned
Sep 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2016

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

Authorized official

Name
Dr. Brian Miller, D.O.NPI 1790882108
Title
Owner/President
Phone
(512) 388-1861

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
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X F4284 TX Primary

Addresses

Primary practice location

2000 N Mays St Ste 109
Round Rock, TX 78664-2166

Mailing address

PO Box 268945
Oklahoma City, OK 73126-8945
Phone (512) 388-1861

Other identifiers 3

IdentifierTypeStateIssuer
1996407-01MedicaidTX
1960571-01MedicaidTX
1960577-01MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050309000651 TX Part B Supplier - Clinic/Group Practice 9335193606 Receives reassigned benefits from 4 practitioners
Practice locations: Round Rock, TX; Killeen, TX; Georgetown, TX

National Provider Directory

National Provider Directory

Locations

1508 Leander Rd
Georgetown, TX 78628
Phone (254) 690-2800

508 Leander Rd
Georgetown, TX 78626
Phone (512) 357-3500

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458172800000",
    "number": "1831294800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 268945",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731268945",
            "telephone_number": "512-388-1861",
            "fax_number": "512-388-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N MAYS ST STE 109",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786642166",
            "telephone_number": "254-690-2800",
            "fax_number": "254-690-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLERGY AND ASTHMA CLINIC OF CENTRAL TEXAS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2016-03-17",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "512-388-1861",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": "TX",
            "license": "F4284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1996407-01",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1960571-01",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1960577-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.