Provider Demographics
NPI:1265628143
Name:EXCEL ENT CLINICS, ASSOCIATED
Entity type:Organization
Organization Name:EXCEL ENT CLINICS, ASSOCIATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HIMMELHEBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-524-3323
Mailing Address - Street 1:107 TEJAS DR
Mailing Address - Street 2:
Mailing Address - City:TERRELL
Mailing Address - State:TX
Mailing Address - Zip Code:75160-6567
Mailing Address - Country:US
Mailing Address - Phone:972-524-3323
Mailing Address - Fax:972-524-0929
Practice Address - Street 1:107 TEJAS DR
Practice Address - Street 2:
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-6567
Practice Address - Country:US
Practice Address - Phone:972-524-3323
Practice Address - Fax:972-524-0929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0062207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00328TOtherMEDICARE PROVIDER NUMBER