Basic Information
| Provider Information | |||||||||
| NPI: | 1174792246 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | AUDIBEL HEARING CENTER OF HENDERSON | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 709 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | HENDERSON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 756543946 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9036571702 | ||||||||
| FaxNumber: | 9036574560 | ||||||||
| Practice Location | |||||||||
| Address1: | 709 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | HENDERSON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 756543946 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9036571702 | ||||||||
| FaxNumber: | 9036574560 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2008 | ||||||||
| LastUpdateDate: | 02/22/2008 | ||||||||
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| AuthorizedOfficialLastName: | GREENVILLE | ||||||||
| AuthorizedOfficialFirstName: | BILLY | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9036571702 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | H.I.S. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332S00000X | 50486 | TX | Y | Suppliers | Hearing Aid Equipment |
No ID Information.