Provider Demographics
NPI:1659349009
Name:AUSTIN OTOLOGY ASSOCIATES PA
Entity Type:Organization
Organization Name:AUSTIN OTOLOGY ASSOCIATES PA
Other - Org Name:AUSTIN EAR CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:W
Authorized Official - Last Name:SLATER
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:512-454-0341
Mailing Address - Street 1:12319 N MOPAC EXPY
Mailing Address - Street 2:BLDG C, SUITE 300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-2403
Mailing Address - Country:US
Mailing Address - Phone:512-454-0341
Mailing Address - Fax:512-454-9915
Practice Address - Street 1:12319 N MOPAC EXPY
Practice Address - Street 2:BLDG C, SUITE 300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-2403
Practice Address - Country:US
Practice Address - Phone:512-454-0341
Practice Address - Fax:512-454-9915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-10
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5006207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & NeurotologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1780691030OtherERIN REHBERG IND. NPI
TX0010CPOtherBCBS GROUP#
TX047540201OtherMEDICAID IND. TPI
TX1942201579OtherKRISTIN ARMSTRONG IND. NPI
TX079793801Medicaid
TX1467440180OtherSLATER IND. NPI
TX1821275504OtherAMY GENSLER IND. NPI
TX87991GOtherBSBC SLATER IND#
TX1467440180OtherSLATER IND. NPI
TX1780691030OtherERIN REHBERG IND. NPI
TX079793801Medicaid
TX00079KMedicare PIN