Basic Information
| Provider Information | |||||||||
| NPI: | 1497027585 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BABER | ||||||||
| FirstName: | BRYAN | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | BC-HIS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6319 W HONEYSUCKLE DR | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850831824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2816676545 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5750 W THUNDERBIRD RD STE F600 | ||||||||
| Address2: | |||||||||
| City: | GLENDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853064667 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6028634203 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2012 | ||||||||
| LastUpdateDate: | 11/13/2019 | ||||||||
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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 | 237700000X | HADE4369 | AZ | Y | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.