Provider Demographics
NPI:1891113338
Name:EAR, NOSE, THROAT & ALLERGY CLINIC OF DALLAS
Entity Type:Organization
Organization Name:EAR, NOSE, THROAT & ALLERGY CLINIC OF DALLAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REYNALDO
Authorized Official - Middle Name:CARLOS
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-691-7546
Mailing Address - Street 1:5952 ROYAL LN STE 120
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-7847
Mailing Address - Country:US
Mailing Address - Phone:214-691-7546
Mailing Address - Fax:214-234-0053
Practice Address - Street 1:5952 ROYAL LN STE 120
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-7847
Practice Address - Country:US
Practice Address - Phone:214-691-7546
Practice Address - Fax:214-234-0053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE2838207Y00000X, 207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic AllergyGroup - Multi-Specialty