Basic Information
| Provider Information | |||||||||
| NPI: | 1508025743 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | LECOMPTE ENTERPRISES | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | |||||||||
| OtherOrganizationName: | AFFORDABLE HEARING CARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 401 W FAIRMONT PKWY | ||||||||
| Address2: | SUITE E | ||||||||
| City: | LA PORTE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775716313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814704722 | ||||||||
| FaxNumber: | 2814704780 | ||||||||
| Practice Location | |||||||||
| Address1: | 401 W FAIRMONT PKWY | ||||||||
| Address2: | SUITE E | ||||||||
| City: | LA PORTE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775716313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814704722 | ||||||||
| FaxNumber: | 2814704780 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2008 | ||||||||
| LastUpdateDate: | 12/12/2012 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | LECOMPTE | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/ DISPENSER | ||||||||
| AuthorizedOfficialTelephone: | 2814704722 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | BS-HIS | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | 50165 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.