1710222039 NPI number — CHEST, ALLERGY AND SLEEP CLINIC PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710222039 NPI number — CHEST, ALLERGY AND SLEEP CLINIC PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHEST, ALLERGY AND SLEEP CLINIC PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710222039
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/20/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3413 SPECTRUM BLVD
Provider Second Line Business Mailing Address:
# 100
Provider Business Mailing Address City Name:
RICHARDSON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75082-9705
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-884-4160
Provider Business Mailing Address Fax Number:
972-668-1618

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4017 E PLANO PKWY STE 400
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLANO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75074-1841
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-665-7100
Provider Business Practice Location Address Fax Number:
866-531-9625
Provider Enumeration Date:
11/28/2012

Additional Information

Authorized Official

Authorized Official Last Name:
ALFARAWATI
Authorized Official First Name:
MOHAMMAD
Authorized Official Middle Name:
N.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
662-801-4975

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  P1724 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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