Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

TEXAS EAR, NOSE & THROAT SPECIALISTS, PLLC
Complete NPI Record 1255314985
Otolaryngology in Mckinney, TX

Name: Complete NPI 1255314985 Record Table
Creator: NPI Profile
License: https://www.cms.gov/data-research/cms-data/data-available-everyone

Active since November 28, 2005CLIA Certified · 10 labs

6717 ELDORADO PKWY STE 140, MCKINNEY, TX 75070(972) 731-7654(972) 731-6226 Get Directions

NPPES record last updated: July 9, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 9, 2026, Jun 1, 2026, Nov 12, 2025 and 4 more (7 updates tracked since 2021).

Complete NPI Dataset

This page contains the complete raw NPPES record for Texas Ear, Nose & Throat Specialists, Pllc (NPI 1255314985), an otolaryngology organization in Mckinney, TX. All 84 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.

Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, Markdown or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.

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Registry File Document Utilities

NPI: 1255314985: The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2: Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: Not available: The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business Name: TEXAS EAR, NOSE & THROAT SPECIALISTS, PLLC: The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Other Organization Name: Not available: Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code: 6: Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address: 10740 N GESSNER DR: The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing Address: STE 310: The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City Name: HOUSTON: The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: TX: The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code: 770641240: The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Country Code If outside U S : US: The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
Provider Business Mailing Address Telephone Number: 2818970416: The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number: 2818908908: The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Provider First Line Business Practice Location Address: 6717 ELDORADO PKWY STE 140: The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: MCKINNEY: The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: TX: The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 750705735: The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US: The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 9727317654: The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 9727316226: The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 11/28/2005: The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 7/9/2026: The date that a record was last updated or changed.
Authorized Official Last Name: MOORHEAD: The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: JOHN: The first name of the authorized official.
Authorized Official Middle Name: C.: The middle name of the authorized official.
Authorized Official Title or Position: PRESIDENT: The title or position of the authorized official.
Authorized Official Telephone Number: 2818908908: The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 207Y00000X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number State Code 1: TX: The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 1: Y: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 2: 207YP0228X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number State Code 2: TX: The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 2: N: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 3: 207YS0012X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number State Code 3: TX: The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 3: N: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 4: 207YS0123X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number State Code 4: TX: The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 4: N: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 5: 207YX0007X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 5: N: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 6: 207YX0602X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 6: N: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 7: 207YX0901X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number State Code 7: TX: The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 7: N: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 8: 207YX0905X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 8: N: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 9: 231H00000X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number State Code 9: TX: The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 9: N: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 10: 237600000X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number State Code 10: TX: The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 10: N: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 11: 363A00000X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number State Code 11: TX: The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 11: N: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Other Provider Identifier 1: 109364302: An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 1: 05: A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier State 1: TX: The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
Other Provider Identifier 2: 081075603: An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 2: 05: A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier State 2: TX: The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
Other Provider Identifier 3: 109364303: An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 3: 05: A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier State 3: TX: The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
Other Provider Identifier 4: 081075602: An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 4: 05: A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier State 4: TX: The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
Is Organization Subpart: N: Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
Authorized Official Credential Text: MD: The professional credential(s) of the authorized official listed on the provider's NPI record. Examples include MD (Doctor of Medicine), DO (Doctor of Osteopathy), RN (Registered Nurse), DDS (Doctor of Dental Surgery), PhD, or other recognized designations that reflect the official's qualifications.
Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP: Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Healthcare Provider Taxonomy Group 2: 193200000X MULTI-SPECIALTY GROUP: Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Healthcare Provider Taxonomy Group 3: 193200000X MULTI-SPECIALTY GROUP: Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Healthcare Provider Taxonomy Group 4: 193200000X MULTI-SPECIALTY GROUP: Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Healthcare Provider Taxonomy Group 5: 193200000X MULTI-SPECIALTY GROUP: Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Healthcare Provider Taxonomy Group 6: 193200000X MULTI-SPECIALTY GROUP: Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Healthcare Provider Taxonomy Group 7: 193200000X MULTI-SPECIALTY GROUP: Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Healthcare Provider Taxonomy Group 8: 193200000X MULTI-SPECIALTY GROUP: Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Healthcare Provider Taxonomy Group 9: 193200000X MULTI-SPECIALTY GROUP: Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Healthcare Provider Taxonomy Group 10: 193200000X MULTI-SPECIALTY GROUP: Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Healthcare Provider Taxonomy Group 11: 193200000X MULTI-SPECIALTY GROUP: Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
NPI Certification Date: 7/9/2026: The date on which the National Provider Identifier (NPI) was officially assigned and certified to the provider. This reflects when the provider's NPI record first became active in the NPPES system.

Other Organization Names 1

Additional business and trade names this provider has on file with the NPPES registry.

Texas Ear Nose & Throat Specialists PA Other Name

1/1

Other Name: Any additional name associated with either an individual provider or an organization that does not fall under the other defined name type categories.

Secondary Practice Locations 31

The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.

5425 W Spring Creek Pkwy Ste 145

1/31

Plano, TX 75024-4278 · Phone (214) 888-8738 · Fax (469) 429-9247

8019 S New Braunfels Ste 120

2/31

San Antonio, TX 78235-1069 · Phone (210) 249-4838

18980 W Memorial Dr Ste 300

3/31

Humble, TX 77338-4559 · Phone (281) 548-2626 · Fax (877) 325-2098

155 School St Ste 210

4/31

Tomball, TX 77375-5382 · Phone (281) 351-8407 · Fax (866) 939-1582

10970 Shadow Creek Pkwy Ste 360

5/31

Pearland, TX 77584-0123 · Phone (713) 436-8071 · Fax (866) 939-1568

21 Spurs Ln Ste 310

6/31

San Antonio, TX 78240-1679 · Phone (210) 615-8332 · Fax (800) 699-0265

15103 Mason Rd Ste C-4

7/31

Cypress, TX 77433-6755 · Phone (832) 678-8330 · Fax (877) 319-1693

150 E Sonterra Blvd Ste 200

8/31

San Antonio, TX 78258-4183 · Phone (210) 249-4838

35 Windmill Cir

9/31

Abilene, TX 79606-5234 · Phone (325) 793-5165 · Fax (325) 793-5346

2510 Crockett Dr

10/31

Brownwood, TX 76801-5928 · Phone (325) 794-5444 · Fax (325) 793-5346

4775 Hamilton Wolfe Rd Ste 1

11/31

San Antonio, TX 78229-3456 · Phone (210) 249-4838

17520 W Grand Pkwy S Ste 440

12/31

Sugar Land, TX 77479-3170 · Phone (832) 678-8350 · Fax (877) 319-1713

10905 Memorial Hermann Dr Ste 117

13/31

Pearland, TX 77584-3490 · Phone (713) 436-8071 · Fax (866) 939-1568

2255 E Mossy Oaks Rd Ste 400

14/31

Spring, TX 77389-1812 · Phone (832) 678-8380 · Fax (866) 950-0316

940 S Legacy Dr Ste 30

15/31

Prosper, TX 75078-2940 · Phone (972) 731-7654 · Fax (972) 731-6226

6565 West Loop S Ste 350

16/31

Bellaire, TX 77401-3500 · Phone (713) 791-9363 · Fax (866) 950-0118

5715 Rogers Rd Ste 128

17/31

San Antonio, TX 78251-3764 · Phone (210) 249-4838

9301 Pinecroft Dr Ste 150

18/31

Shenandoah, TX 77380-3182 · Phone (281) 362-1368 · Fax (888) 905-2328

4015 Interstate 45 N Ste 330

19/31

Conroe, TX 77304-5077 · Phone (936) 539-4700 · Fax (936) 539-6618

42 Gruene Park Dr

20/31

New Braunfels, TX 78130-2460 · Phone (830) 629-5830 · Fax (830) 629-3647

18707 Hardy Oak Blvd Ste 475

21/31

San Antonio, TX 78258-5063 · Phone (210) 499-4589 · Fax (866) 939-1366

5512 W Plano Pkwy Ste 100

22/31

Plano, TX 75093-4840 · Phone (972) 731-7654 · Fax (972) 731-6226

23920 Katy Fwy Ste 430

23/31

Katy, TX 77494-0881 · Phone (281) 347-6700 · Fax (888) 714-0525

2016 W White St Ste 100

24/31

Anna, TX 75409-5678 · Phone (972) 731-7654 · Fax (972) 731-6226

24510 Northwest Fwy Ste 680

25/31

Cypress, TX 77429-2903 · Phone (281) 890-6155 · Fax (888) 905-2348

11970 N Central Expy Ste 400

26/31

Dallas, TX 75243-3787 · Phone (214) 888-8738 · Fax (214) 385-5198

8731 Katy Fwy Ste 200

27/31

Houston, TX 77024-1735 · Phone (713) 781-9660 · Fax (800) 715-7365

251 W Medical Center Blvd Ste 110

28/31

Webster, TX 77598-4242 · Phone (281) 338-1423 · Fax (800) 876-1456

18400 Katy Fwy Ste 470

29/31

Houston, TX 77094-1287 · Phone (281) 492-7827 · Fax (888) 714-0525

4401 Coit Rd Ste 411

30/31

Frisco, TX 75035-0520 · Phone (972) 731-7654 · Fax (972) 731-6226

20207 Chasewood Park Dr Ste 100

31/31

Houston, TX 77070-1441 · Phone (832) 237-2227 · Fax (866) 939-1550

Other Provider Identifiers 4

Legacy and payer-issued identifiers reported to the NPPES registry for this provider.

109364302 Medicaid

1/4

State: TX
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.

081075603 Medicaid

2/4

State: TX
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.

109364303 Medicaid

3/4

State: TX
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.

081075602 Medicaid

4/4

State: TX
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.

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