Provider Demographics
NPI:1174505473
Name:BUTLER & BURNS EAR NOSE & THROAT ASSOCIATES
Entity Type:Organization
Organization Name:BUTLER & BURNS EAR NOSE & THROAT ASSOCIATES
Other - Org Name:AUSTIN EAR, NOSE & THROAT CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRADFORD
Authorized Official - Middle Name:C
Authorized Official - Last Name:WINEGAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-454-0392
Mailing Address - Street 1:3705 MEDICAL PKWY
Mailing Address - Street 2:SUITE 320
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1019
Mailing Address - Country:US
Mailing Address - Phone:512-454-0392
Mailing Address - Fax:512-454-6019
Practice Address - Street 1:3705 MEDICAL PKWY
Practice Address - Street 2:SUITE 320
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1019
Practice Address - Country:US
Practice Address - Phone:512-454-0392
Practice Address - Fax:512-454-6019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Multi-Specialty
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Multi-Specialty
No207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & NeurotologyGroup - Multi-Specialty
No207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0414630005OtherDME MAC
TX121718401Medicaid
0414630001OtherDME MAC
TX121718403Medicaid
0414630002OtherDME MAC
0414630003OtherDME MAC
0414630004OtherDME MAC
00L348Medicare PIN
0414630004OtherDME MAC
0414630002Medicare NSC
0414630005OtherDME MAC
TX121718401Medicaid
TX121718403Medicaid
00U70MMedicare PIN