Provider Demographics
NPI:1306984992
Name:GEORGETOWN EAR, NOSE AND THROAT CENTER, PA
Entity type:Organization
Organization Name:GEORGETOWN EAR, NOSE AND THROAT CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR AND PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-869-0604
Mailing Address - Street 1:3201 S AUSTIN AVE
Mailing Address - Street 2:SUITE 370
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-7545
Mailing Address - Country:US
Mailing Address - Phone:512-869-0604
Mailing Address - Fax:512-868-5936
Practice Address - Street 1:3201 S AUSTIN AVE
Practice Address - Street 2:SUITE 370
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-7545
Practice Address - Country:US
Practice Address - Phone:512-869-0604
Practice Address - Fax:512-868-5936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-03
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0033JKOtherGENT BCBS GROUP #
TX154066801Medicaid
TX154066801Medicaid