Provider Demographics
NPI:1790019784
Name:EAR NOSE AND THROAT ASSOCIATES OF LUBBOCK PA
Entity Type:Organization
Organization Name:EAR NOSE AND THROAT ASSOCIATES OF LUBBOCK PA
Other - Org Name:PHILIP A SCOLARO, MD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCOLARO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-791-0188
Mailing Address - Street 1:3802 22ND ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1107
Mailing Address - Country:US
Mailing Address - Phone:806-791-0188
Mailing Address - Fax:806-788-0470
Practice Address - Street 1:3802 22ND ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1107
Practice Address - Country:US
Practice Address - Phone:806-791-0188
Practice Address - Fax:806-788-0470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-24
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CD477OtherGROUP BCBS