Provider Demographics
NPI:1114127891
Name:DATA 2 INFORMATION CORP.
Entity Type:Organization
Organization Name:DATA 2 INFORMATION CORP.
Other - Org Name:WEST LAKE HEARING & BALANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:D
Authorized Official - Last Name:PIPPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-798-7624
Mailing Address - Street 1:3201 BEE CAVE RD
Mailing Address - Street 2:STE. 146
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6771
Mailing Address - Country:US
Mailing Address - Phone:512-327-8845
Mailing Address - Fax:512-327-8843
Practice Address - Street 1:3201 BEE CAVE RD
Practice Address - Street 2:STE. 146
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6771
Practice Address - Country:US
Practice Address - Phone:512-327-8845
Practice Address - Fax:512-327-8843
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DATA 2 INFORMATION CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-20
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50552237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00170SMedicare PIN