Provider Demographics
NPI:1093839342
Name:EAR, NOSE AND THROAT ASSOCIATES OF FRISCO, P.A.
Entity Type:Organization
Organization Name:EAR, NOSE AND THROAT ASSOCIATES OF FRISCO, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NEELESH
Authorized Official - Middle Name:H
Authorized Official - Last Name:MEHENDALE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-731-7654
Mailing Address - Street 1:4401 COIT RD
Mailing Address - Street 2:SUITE 411
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-0500
Mailing Address - Country:US
Mailing Address - Phone:972-731-7654
Mailing Address - Fax:972-731-6226
Practice Address - Street 1:4401 COIT RD
Practice Address - Street 2:SUITE 411
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-0500
Practice Address - Country:US
Practice Address - Phone:972-731-7654
Practice Address - Fax:972-731-6226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0015LMOtherGROUP BCBS ID
TXDC5894OtherGROUP RAILROAD MEDICARE
TX00932WMedicare ID - Type UnspecifiedGROUP MEDICARE ID