Provider Demographics
NPI:1760663595
Name:SYLVAN BARTLETT PA
Entity Type:Organization
Organization Name:SYLVAN BARTLETT PA
Other - Org Name:EASTERN NEW MEXICO EAR, NOSE, AND THROAT ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SYLVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTLETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:575-392-0404
Mailing Address - Street 1:1900 PECAN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-8313
Mailing Address - Country:US
Mailing Address - Phone:214-592-0404
Mailing Address - Fax:214-592-0404
Practice Address - Street 1:5419 N LOVINGTON HWY
Practice Address - Street 2:COMPLEX 5, SUITE 7
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-9131
Practice Address - Country:US
Practice Address - Phone:575-392-0404
Practice Address - Fax:575-393-0093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM87317207Y00000X
TXE7810208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty