MEDICARE: TEXAS EAR AND VESTIBULAR INSTITUTE

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	163WW0000X	Wound Care Registered Nurse
2	207Y00000X	Otolaryngology Physician

General Provider Information

NPI Number	:	1629634043
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS EAR AND VESTIBULAR INSTITUTE

Provider Business Mailing Address
First Line	:	101 BOURLAND RD STE D
Second Line	:
City	:	KELLER
State	:	TX
Zip	:	76248-3507
Country	:	US
Telephone Number	:	833-818-8383
Fax Number	:	817-889-8134

Provider Business Practice Location Address
First Line	:	101 BOURLAND RD STE D
Second Line	:
City	:	KELLER
State	:	TX
Zip	:	76248-3507
Country	:	US
Telephone Number	:	833-818-8383
Fax Number	:	817-889-8134

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	ANDREW SENCHAK
Credential	:	DO
Telephone Number	:	808-295-8999

Provider Enumeration Date	:	05/10/2019
Last Update Date	:	02/10/2026

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