1326635533 NPI number — AUDIOLOGY HEARING AID CENTER LLC

Table of content: (NPI 1326635533)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326635533 NPI number — AUDIOLOGY HEARING AID CENTER LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AUDIOLOGY HEARING AID CENTER LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
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Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
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NPI Number Information

NPI Number:
1326635533
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3109 DOUGLAS AVE APT 139
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75219-3549
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-244-1915
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
350 WESTPARK WAY STE 221
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EULESS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76040-3740
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
469-661-3200
Provider Business Practice Location Address Fax Number:
469-649-9600
Provider Enumeration Date:
12/22/2020

Additional Information

Authorized Official

Authorized Official Last Name:
MORALES
Authorized Official First Name:
JOE
Authorized Official Middle Name:
Authorized Official Title or Position:
HEARING AID DISPENSER
Authorized Official Telephone Number:
214-244-1915

Provider Taxonomy Codes

  • Taxonomy code: 2355A2700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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