MEDICARE: SINUS REGISTRY, PLLC

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	207Y00000X	Otolaryngology Physician

General Provider Information

NPI Number	:	1760728588
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SINUS REGISTRY, PLLC

Provider Business Mailing Address
First Line	:	3112 GREENBRIER DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75225-4602
Country	:	US
Telephone Number	:	214-345-5702
Fax Number	:

Provider Business Practice Location Address
First Line	:	3112 GREENBRIER DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75225-4602
Country	:	US
Telephone Number	:	214-345-5702
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FORD D ALBRITTON IV
Credential	:	MD
Telephone Number	:	214-345-5702

Provider Enumeration Date	:	12/26/2012
Last Update Date	:	12/26/2012

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