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General NPI Number Information
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NPI Number | 1528085206
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Entity Type | Organization
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Legal Business Name | EAR, NOSE & THROAT ASSOCIATES OF CORPUS CHRISTI
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 03/06/2023
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Provider Practice Location Address
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Address Line | 5959 S STAPLES ST STE 102
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City | CORPUS CHRISTI
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State | TX
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Zip | 78413-3844
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Country | US
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Telephone | 361-854-7000
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Fax | 361-814-2685
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Provider Business Mailing Address
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Address Line | 5959 S STAPLES ST STE 102
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City | CORPUS CHRISTI
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State | TX
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Zip | 78413-3844
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Country | US
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Telephone | 361-854-7000
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Fax | 361-814-2685
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Authorized Official
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Title or Position | BUSINESS OFFICE MANAGER
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Name | MS. SYLVIA GONZALES
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Credential |
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Telephone | 361-854-7000
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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 | 0080251703
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License Number State | TX
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