MEDICARE: TEXAS ENT & ALLERGY ASSOCIATES, 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	207Y00000X	Otolaryngology Physician

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
2	0097MS	OTHER	TX	BLUE CROSS GROUP NUMBER

General Provider Information

NPI Number	:	1962517672
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS ENT & ALLERGY ASSOCIATES, LLP

Provider Business Mailing Address
First Line	:	PO BOX 165899
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75016-5899
Country	:	US
Telephone Number	:	979-693-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1730 BIRMINGHAM RD
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77845-4063
Country	:	US
Telephone Number	:	979-693-6000
Fax Number	:	979-693-1900

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RONALD B KUPPERSMITH
Credential	:	M.D.
Telephone Number	:	979-693-6000

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	12/29/2025

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Directions to “TEXAS ENT & ALLERGY ASSOCIATES, LLP ” Practice Location

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