Provider Demographics
NPI:1114681814
Name:BREATHE ENT
Entity Type:Organization
Organization Name:BREATHE ENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-879-1461
Mailing Address - Street 1:1401 MEDICAL PKWY STE 407
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-5015
Mailing Address - Country:US
Mailing Address - Phone:512-879-1461
Mailing Address - Fax:512-879-1462
Practice Address - Street 1:1401 MEDICAL PKWY STE 407
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-5015
Practice Address - Country:US
Practice Address - Phone:512-879-1461
Practice Address - Fax:512-879-1462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-28
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty