Provider Demographics
NPI:1992901946
Name:ENT SPECIALISTS OF AUSTIN PA
Entity type:Organization
Organization Name:ENT SPECIALISTS OF AUSTIN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:E
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-346-7600
Mailing Address - Street 1:720 W 34TH ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1205
Mailing Address - Country:US
Mailing Address - Phone:512-346-7600
Mailing Address - Fax:512-346-7603
Practice Address - Street 1:720 W 34TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1205
Practice Address - Country:US
Practice Address - Phone:512-346-7600
Practice Address - Fax:512-346-7603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0015PXOtherBCBS GROUP #
TX190905301Medicaid
TX190905301Medicaid
TX00Y251Medicare PIN