Provider Demographics
NPI:1346514759
Name:BROOKS HEARING,LLC
Entity Type:Organization
Organization Name:BROOKS HEARING,LLC
Other - Org Name:BROOKS HEARING CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:COSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-737-8800
Mailing Address - Street 1:3130 LAMAR AVE
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-5020
Mailing Address - Country:US
Mailing Address - Phone:903-737-8800
Mailing Address - Fax:903-784-8429
Practice Address - Street 1:5002 SAYLE ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75402-6355
Practice Address - Country:US
Practice Address - Phone:903-274-4700
Practice Address - Fax:903-454-3140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-02
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX089238202Medicaid
TX089238202Medicaid