Basic Information
Provider Information | |||||||||
NPI: | 1891903795 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | MCCRAE MANAGEMENT & INVESTMENTS, LTD. | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: | NEWSOUND HEARING AID CENTERS | ||||||||
OtherOrganizationType: | 3 | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 26222 RR 12 | ||||||||
Address2: |   | ||||||||
City: | DRIPPING SPRINGS | ||||||||
State: | TX | ||||||||
PostalCode: | 786204903 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5128580300 | ||||||||
FaxNumber: | 5128582714 | ||||||||
Practice Location | |||||||||
Address1: | 26222 RR 12 | ||||||||
Address2: |   | ||||||||
City: | DRIPPING SPRINGS | ||||||||
State: | TX | ||||||||
PostalCode: | 786204903 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5128580300 | ||||||||
FaxNumber: | 5128582714 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/21/2007 | ||||||||
LastUpdateDate: | 07/26/2012 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | SCHOENBORN | ||||||||
AuthorizedOfficialFirstName: | RANDY | ||||||||
AuthorizedOfficialMiddleName: | L | ||||||||
AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
AuthorizedOfficialTelephone: | 5128580300 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332S00000X |   |   | N |   | Suppliers | Hearing Aid Equipment |   | 237700000X | 50331 | TX | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |   |
ID Information
ID | Type | State | Issuer | Description | 179031301 | 05 | TX |   | MEDICAID |