Provider Demographics
NPI:1104197813
Name:BETHEL HEARING AND SPEAKING TRAINING CENTER INC.
Entity Type:Organization
Organization Name:BETHEL HEARING AND SPEAKING TRAINING CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:XUEMAN
Authorized Official - Middle Name:LUCY
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-734-4776
Mailing Address - Street 1:14414 SHOREDALE LN
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-2050
Mailing Address - Country:US
Mailing Address - Phone:214-734-4776
Mailing Address - Fax:
Practice Address - Street 1:14414 SHOREDALE LN
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-2050
Practice Address - Country:US
Practice Address - Phone:214-734-4776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-26
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60520231H00000X
TX101194235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty