Provider Demographics
NPI:1609065242
Name:BUTLER & BURNS EAR NOSE & THROAT
Entity Type:Organization
Organization Name:BUTLER & BURNS EAR NOSE & THROAT
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 1:441 HIGHWAY 71 W
Practice Address - Street 2:SUITE H
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-3931
Practice Address - Country:US
Practice Address - Phone:512-454-0392
Practice Address - Fax:512-454-6019
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BUTLER & BURNS EAR NOSE & THROAT ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-19
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5842207Y00000X
207Y00000X, 207YS0123X, 207YX0007X, 207YX0901X, 207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single 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
00U70MMedicare PIN