MEDICARE: CENTRAL TEXAS ENT, LLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	J5638	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629293279
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL TEXAS ENT, LLP

Provider Business Mailing Address
First Line	:	2805 EARL RUDDER FWY S
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77845-6080
Country	:	US
Telephone Number	:	979-680-8808
Fax Number	:	979-695-6517

Provider Business Practice Location Address
First Line	:	2805 EARL RUDDER FWY S
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77845-6080
Country	:	US
Telephone Number	:	979-680-8808
Fax Number	:	979-695-6517

Authorized Official
Title or Position	:	OWNER
Name	:	THOMAS A SALZER
Credential	:	M.D.
Telephone Number	:	979-680-8808

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	10/31/2008

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Directions to “CENTRAL TEXAS ENT, LLP ” Practice Location

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