Basic Information
| Provider Information | |||||||||
| NPI: | 1114196540 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | PEDROZA | ||||||||
| FirstName: | RENE | ||||||||
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| Credential: | AU.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | SAVAHCS AUDIOLOGY DEPARTMENT 5-126 | ||||||||
| Address2: | 3601 S. 6TH AVE | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857230001 | ||||||||
| CountryCode: | US | ||||||||
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| Address1: | SAVAHCS AUDIOLOGY DEPARTMENT 5-126 | ||||||||
| Address2: | 3601 S. 6TH AVE | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857230001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5207921450 | ||||||||
| FaxNumber: | 5206294707 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/29/2008 | ||||||||
| LastUpdateDate: | 02/29/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237600000X | Y | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter |
No ID Information.