Ear, Nose and Throat (ENT) Legacy

To Request an Appointment

  1. Submit the following to 469-303-4720 (FAX)

    • Standard Cover Page

    • All relevant clinical documentation (e.g. prior hearing tests, labs, x-rays)

    • Aetna Medicaid, Oklahoma Medicaid – Humana Tricare PRIME must have referral – Out of Network

    • Legacy T&A’s: Amerigroup Criteria Verification

      • T&A's: We need at least 7 documented visits with dates and chief complaints of that visit listed and sent to us for any Amerigroup patients. Amerigroup criteria asked for 7 documented dates of occurrence within the last year.

  2. Please ask the family to call 469-303-4700 to schedule an appointment

    • When the family calls us, we will schedule them (with the exception of Amerigroup patients)


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