Provider Demographics
NPI:1427232511
Name:TEJAS EAR, NOSE AND THROAT P.A.
Entity Type:Organization
Organization Name:TEJAS EAR, NOSE AND THROAT P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:ARNOLDO
Authorized Official - Last Name:TAMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-255-8070
Mailing Address - Street 1:7201 WYOMING SPRINGS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-4311
Mailing Address - Country:US
Mailing Address - Phone:512-255-8070
Mailing Address - Fax:512-255-9060
Practice Address - Street 1:7201 WYOMING SPRINGS DR STE 100
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4311
Practice Address - Country:US
Practice Address - Phone:512-255-8070
Practice Address - Fax:512-255-9060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7858174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX179471101Medicaid