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General NPI Number Information
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NPI Number | 1417039512
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Entity Type | Organization
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Legal Business Name | ALLERGY EARS NOSE & THROAT OF GREENVILLE PA
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 02/18/2015
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Provider Practice Location Address
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Address Line | 3000 HORIZON RD
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City | ROCKWALL
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State | TX
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Zip | 75032-5817
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Country | US
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Telephone | 903-454-6481
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Fax | 903-454-6486
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Provider Business Mailing Address
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Address Line | 3000 HORIZON RD
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City | ROCKWALL
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State | TX
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Zip | 75032-5817
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Country | US
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Telephone | 903-454-6481
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Fax | 903-454-6486
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Authorized Official
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Title or Position | OWNER
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Name | THOMAS V RIPP
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Credential | MD
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Telephone | 903-454-6481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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