Provider Demographics
NPI:1538350319
Name:ENT SPECIALISTS OF NORTH TEXAS
Entity type:Organization
Organization Name:ENT SPECIALISTS OF NORTH TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KAMBEITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-398-8777
Mailing Address - Street 1:4001 W 15TH ST STE 335
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5859
Mailing Address - Country:US
Mailing Address - Phone:972-398-8777
Mailing Address - Fax:972-398-8788
Practice Address - Street 1:4001 W 15TH ST STE 335
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5859
Practice Address - Country:US
Practice Address - Phone:972-398-8777
Practice Address - Fax:972-398-8788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2353207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI49278Medicare UPIN
TX00W084Medicare PIN