Basic Information
Provider Information | |||||||||
NPI: | 1023142023 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | SWIFT | ||||||||
FirstName: | BILLIE | ||||||||
MiddleName: | B. | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | AU.D | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 8800 SE SUNNYSIDE RD STE 300N | ||||||||
Address2: |   | ||||||||
City: | CLACKAMAS | ||||||||
State: | OR | ||||||||
PostalCode: | 970155703 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2812862999 | ||||||||
FaxNumber: | 5126074893 | ||||||||
Practice Location | |||||||||
Address1: | 1901 TOWN CENTRE DR STE 130 | ||||||||
Address2: |   | ||||||||
City: | ROUND ROCK | ||||||||
State: | TX | ||||||||
PostalCode: | 786647464 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5122388006 | ||||||||
FaxNumber: | 5122388065 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 03/14/2007 | ||||||||
LastUpdateDate: | 01/16/2018 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 7659 | NC | N |   | Speech, Language and Hearing Service Providers | Audiologist |   | 237700000X |   | TX | N |   | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |   | 237600000X | 1276 | NC | Y |   | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter |   |
ID Information
ID | Type | State | Issuer | Description | 548457ZWGX | 01 | TX | MEDICARE | OTHER |