Healthcare Provider Details

I. General information

NPI: 1942407473
Provider Name (Legal Business Name): ENT SPECIALISTS OF AUSTIN PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2007
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1513 E NEW HOPE DR BLDG D
CEDAR PARK TX
78641-5760
US

IV. Provider business mailing address

720 W 34TH ST STE 110
AUSTIN TX
78705-1202
US

V. Phone/Fax

Practice location:
  • Phone: 512-346-7600
  • Fax: 512-346-7603
Mailing address:
  • Phone: 512-346-7600
  • Fax: 512-346-7603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: DR. LINDSAY E YOUNG
Title or Position: PRESIDENT
Credential: MD
Phone: 512-346-7600