Provider Demographics
NPI:1508991969
Name:OTOLARYNGOLOGY AND HEAD & NECK SURGERY ASSOCIATES, LLP
Entity Type:Organization
Organization Name:OTOLARYNGOLOGY AND HEAD & NECK SURGERY ASSOCIATES, LLP
Other - Org Name:THE ENT GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:K
Authorized Official - Last Name:HOWRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-793-0691
Mailing Address - Street 1:4214 TEXAS BLVD
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-3013
Mailing Address - Country:US
Mailing Address - Phone:903-793-0691
Mailing Address - Fax:903-794-2046
Practice Address - Street 1:4214 TEXAS BLVD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-3013
Practice Address - Country:US
Practice Address - Phone:903-793-0691
Practice Address - Fax:903-794-2046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty