Provider Demographics
NPI:1093143521
Name:ASSOCIATES OF AUDIOLOGY LLC
Entity Type:Organization
Organization Name:ASSOCIATES OF AUDIOLOGY LLC
Other - Org Name:ASSOCIATES OF AUDIOLOGY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:210-848-7696
Mailing Address - Street 1:1202 E SONTERRA BLVD STE 302
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4090
Mailing Address - Country:US
Mailing Address - Phone:210-334-0245
Mailing Address - Fax:210-334-0232
Practice Address - Street 1:1202 E SONTERRA BLVD STE 302
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4090
Practice Address - Country:US
Practice Address - Phone:210-334-0245
Practice Address - Fax:210-334-0232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-18
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231H00000X, 237600000X, 237700000X
TX80219302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
No302F00000XManaged Care OrganizationsExclusive Provider OrganizationGroup - Multi-Specialty