Provider Demographics
NPI:1407150899
Name:PROFESSIONAL HEARING ASSOCIATES
Entity Type:Organization
Organization Name:PROFESSIONAL HEARING ASSOCIATES
Other - Org Name:GALCO HEARING AID SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:D
Authorized Official - Last Name:BUSSCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-326-2612
Mailing Address - Street 1:2622 NASA PKWY
Mailing Address - Street 2:G-1
Mailing Address - City:SEABROOK
Mailing Address - State:TX
Mailing Address - Zip Code:77586-3459
Mailing Address - Country:US
Mailing Address - Phone:281-326-2612
Mailing Address - Fax:
Practice Address - Street 1:2622 NASA PKWY
Practice Address - Street 2:G-1
Practice Address - City:SEABROOK
Practice Address - State:TX
Practice Address - Zip Code:77586-3459
Practice Address - Country:US
Practice Address - Phone:281-326-2612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-29
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50156237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty