Provider Demographics
NPI:1780709675
Name:COMPREHENSIVE ENT CENTER OF TEXAS
Entity type:Organization
Organization Name:COMPREHENSIVE ENT CENTER OF TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:LEEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-478-2273
Mailing Address - Street 1:3607 MANOR RD
Mailing Address - Street 2:#101
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723
Mailing Address - Country:US
Mailing Address - Phone:512-478-2273
Mailing Address - Fax:512-472-0921
Practice Address - Street 1:3607 MANOR RD STE 101
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-5818
Practice Address - Country:US
Practice Address - Phone:512-478-2273
Practice Address - Fax:512-472-0921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0022EVOtherBCBS GROUP #
TX081445101Medicaid
TX00967NMedicare ID - Type Unspecified