Provider Demographics
NPI:1699701193
Name:ANTHONY R. BITTAR, M.D, P.A.
Entity type:Organization
Organization Name:ANTHONY R. BITTAR, M.D, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER, M.A.
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:BEATRICE
Authorized Official - Last Name:WERSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-448-4422
Mailing Address - Street 1:4101 JAMES CASEY STREET
Mailing Address - Street 2:STE 310
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1145
Mailing Address - Country:US
Mailing Address - Phone:512-448-4422
Mailing Address - Fax:512-448-4463
Practice Address - Street 1:4101 JAMES CASEY ST
Practice Address - Street 2:STE 310
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1145
Practice Address - Country:US
Practice Address - Phone:512-448-4422
Practice Address - Fax:512-448-4463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7621207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0082PZOtherBCBS
TX00Z413Medicare PIN