Provider Demographics
NPI:1235641671
Name:FRISCO HEARING & TINNITUS ASSOCIATES LLC
Entity Type:Organization
Organization Name:FRISCO HEARING & TINNITUS ASSOCIATES LLC
Other - Org Name:NORTH TEXAS TINNITUS ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:AUDIOLOGIST/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TYSHA
Authorized Official - Middle Name:MOANA
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:404-484-6305
Mailing Address - Street 1:425 OLD NEWMAN RD STE 504
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4772
Mailing Address - Country:US
Mailing Address - Phone:404-484-6305
Mailing Address - Fax:
Practice Address - Street 1:425 OLD NEWMAN RD STE 504
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4772
Practice Address - Country:US
Practice Address - Phone:404-484-6305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-25
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80517231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty