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General NPI Number Information
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NPI Number | 1609175280
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Entity Type | Organization
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Legal Business Name | TEXAN ENT & ALLERGY ASSOCIATES
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Dates
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Enumeration Date | 03/22/2011
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Last Update Date | 04/21/2015
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Provider Practice Location Address
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Address Line | 1180 SETON PARKWAY SUITE 330
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City | KYLE
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State | TX
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Zip | 78640-6179
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Country | US
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Telephone | 512-550-0321
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Fax | 512-268-4600
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Provider Business Mailing Address
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Address Line | 1180 SETON PARKWAY SUITE 330
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City | KYLE
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State | TX
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Zip | 78640-6179
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Country | US
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Telephone | 512-550-0321
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Fax | 512-268-4600
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | MS. ALLIE VITEK
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Credential |
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Telephone | 512-413-1342
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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 | J4559
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License Number State | TX
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