Healthcare Provider Details
I. General information
NPI: 1306984992
Provider Name (Legal Business Name): GEORGETOWN EAR, NOSE AND THROAT CENTER, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/03/2007
Last Update Date: 07/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3201 S AUSTIN AVE SUITE 370
GEORGETOWN TX
78626-7545
US
IV. Provider business mailing address
3201 S AUSTIN AVE SUITE 370
GEORGETOWN TX
78626-7545
US
V. Phone/Fax
- Phone: 512-869-0604
- Fax: 512-868-5936
- Phone: 512-869-0604
- Fax: 512-868-5936
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SCOTT
WILLIAM
FRANKLIN
Title or Position: MEDICAL DIRECTOR AND PRESIDENT
Credential: M.D.
Phone: 512-869-0604