Organization Active NPI

Allergy, Asthma & Immunology Center, PLLC

  • Medical Specialty Clinic/Center
  • Murphy, TX
National Provider Identifier
1982026480
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
P4113 Issued in TX
Legal business name
ALLERGY, ASTHMA & IMMUNOLOGY CENTER, PLLC
Practice address
623 W FM 544
Ste 104
Murphy, TX 75094-4577
Phone
(972) 521-3366
Fax
(972) 422-5656
NPI assigned
Jan 17, 2014
Last updated
Oct 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Authorized official

Name
Srividya Sridhara, MDNPI 1477695351
Title
Manager/Owner
Phone
(972) 521-3366

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
Medical Specialty Clinic/Center 261QM2500X P4113 TX Primary

Addresses

Primary practice location

623 W FM 544
Ste 104
Murphy, TX 75094-4577

Mailing address

6210 Georgian CT
Dallas, TX 75254-8652
Phone (408) 431-0256

Other practice location 1

8080 Independence Pkwy Ste 235
Plano, TX 75025-4014
Phone (972) 521-3366

Other identifiers 1

IdentifierTypeStateIssuer
TXB165560OtherTXTEXAS MEDICARE IDENTIFICATION NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140915000476 TX Part B Supplier - Clinic/Group Practice 0648499269 Receives reassigned benefits from 1 practitioner
Practice locations: Murphy, TX

National Provider Directory

National Provider Directory

Locations

345 W FM 544
Ste 100
Murphy, TX 75094
Phone (972) 578-7700

Practitioners & affiliated clinicians

Practitioners 2

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": "1389916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1982026480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 GEORGIAN CT",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752548652",
            "telephone_number": "408-431-0256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 W FM 544",
            "address_2": "STE 104",
            "city": "MURPHY",
            "state": "TX",
            "postal_code": "750944577",
            "telephone_number": "972-521-3366",
            "fax_number": "972-422-5656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8080 Independence Pkwy Ste 235",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750254014",
            "country_code": "US",
            "telephone_number": "972-521-3366",
            "fax_number": "972-422-5656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ALLERGY, ASTHMA & IMMUNOLOGY CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-17",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A",
        "authorized_official_last_name": "SRIDHARA",
        "authorized_official_first_name": "SRIVIDYA",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "972-521-3366",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "TX",
            "license": "P4113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICARE IDENTIFICATION NUMBER",
            "identifier": "TXB165560",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murphy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.