Basic Information
| Provider Information | |||||||||
| NPI: | 1942567128 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | METX LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 204 WOODHEW DR | ||||||||
| Address2: | |||||||||
| City: | WACO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 767126529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2548700574 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1575 W GRAND PKWY S | ||||||||
| Address2: | STE 900 | ||||||||
| City: | KATY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77494 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8324376566 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2012 | ||||||||
| LastUpdateDate: | 07/11/2018 | ||||||||
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| AuthorizedOfficialLastName: | CARROLL | ||||||||
| AuthorizedOfficialFirstName: | KENNY | ||||||||
| AuthorizedOfficialMiddleName: | LYNN | ||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 2545374421 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist | 237600000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter |
No ID Information.