Texas ENT & Allergy – Otolaryngology Physician, NPI 1962517672
Otolaryngology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Texas ENT & Allergy
1602, Rock Prairie Road, College Station, Brazos County, Texas, 77845, United States
SUITE 230
COLLEGE STATION, TX 778458306
Phone: (979) 693-6000
Type: Mailing
539 Medical Pkwy
Brenham, TX 778335405
Phone: (979) 353-5509
Type: Location
601 W State Highway 6 Ste 106
Waco, TX 767105592
Phone: (979) 693-6000
Type: Location
122 Medical Park Ln Ste A
Huntsville, TX 773404902
Phone: (877) 377-4368
Type: Location
1730 BIRMINGHAM RD
COLLEGE STATION, TX 778454063
Phone: (979) 693-6000
Fax: (979) 693-1900
Type: Location
PO BOX 10194
COLLEGE STATION, TX 778420194
Phone: (979) 693-6000
Type: Mailing
PO BOX 165899
IRVING, TX 750165899
Phone: (979) 693-6000
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2005-08-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-12-31 (159 days ago).
Enrollment records
1
Earliest due date
2025-12-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20050810000650 | O | Clinic/Group Practice | TX | 2025-12-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 77845)
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Reviews
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