Provider Demographics
NPI:1003352741
Name:MASTERS HEARING AID CENTER, INC.
Entity Type:Organization
Organization Name:MASTERS HEARING AID CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:FAIN
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:432-557-2702
Mailing Address - Street 1:PO BOX 60449
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79711-0449
Mailing Address - Country:US
Mailing Address - Phone:432-557-2702
Mailing Address - Fax:832-369-7394
Practice Address - Street 1:4220 WENDOVER AVE
Practice Address - Street 2:STE A
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-5925
Practice Address - Country:US
Practice Address - Phone:432-557-2702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80240237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty