Provider Demographics
NPI:1295008225
Name:COLEMAN-WEBER LLC
Entity Type:Organization
Organization Name:COLEMAN-WEBER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN-WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-794-5839
Mailing Address - Street 1:5124 SUMMERHILL RD
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-1824
Mailing Address - Country:US
Mailing Address - Phone:903-794-5839
Mailing Address - Fax:
Practice Address - Street 1:5124 SUMMERHILL RD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-1824
Practice Address - Country:US
Practice Address - Phone:903-794-5839
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50323231H00000X
ARA167231H00000X
TX90040237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty