Provider Demographics
NPI:1316187701
Name:DISCOUNT HEARING AID CENTERS OF TEXAS, INC.
Entity Type:Organization
Organization Name:DISCOUNT HEARING AID CENTERS OF TEXAS, INC.
Other - Org Name:DISCOUNT HEARING AIDS OF TEXAS, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:W
Authorized Official - Last Name:LOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-661-1140
Mailing Address - Street 1:PO BOX 11597
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77391-1597
Mailing Address - Country:US
Mailing Address - Phone:713-661-1140
Mailing Address - Fax:713-661-1155
Practice Address - Street 1:5909 WEST LOOP S
Practice Address - Street 2:STE 115
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2402
Practice Address - Country:US
Practice Address - Phone:713-661-1140
Practice Address - Fax:713-661-1155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-25
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50142237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2044406-01Medicaid