Provider Demographics
NPI:1255314985
Name:TEXAS EAR, NOSE & THROAT SPECIALISTS, PLLC
Entity Type:Organization
Organization Name:TEXAS EAR, NOSE & THROAT SPECIALISTS, PLLC
Other - Org Name:TEXAS EAR NOSE & THROAT SPECIALISTS PA
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:MOORHEAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-890-8908
Mailing Address - Street 1:10740 N GESSNER DR
Mailing Address - Street 2:STE 310
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-1240
Mailing Address - Country:US
Mailing Address - Phone:281-897-0416
Mailing Address - Fax:281-890-8908
Practice Address - Street 1:21216 NORTHWEST FREEWAY
Practice Address - Street 2:STE 310
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-4698
Practice Address - Country:US
Practice Address - Phone:281-890-6155
Practice Address - Fax:888-905-2348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-28
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207Y00000X, 207YP0228X, 207YS0012X, 207YS0123X, 207YX0901X, 231H00000X, 237600000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric OtolaryngologyGroup - Multi-Specialty
No207YS0012XAllopathic & Osteopathic PhysiciansOtolaryngologySleep MedicineGroup - Multi-Specialty
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Multi-Specialty
No207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & NeurotologyGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX081075603Medicaid
TX109364302Medicaid
TX081075602Medicaid
TX109364303Medicaid
TX081075603Medicaid
TX109364303Medicaid
TX0073BHMedicare PIN
TX00333NMedicare PIN
TX109364302Medicaid