Provider Demographics
NPI:1417363235
Name:ADULT & PEDIATRIC HEARING AIDS & AUDIOLOGY OF THE WOODLANDS, PLLC
Entity Type:Organization
Organization Name:ADULT & PEDIATRIC HEARING AIDS & AUDIOLOGY OF THE WOODLANDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-203-5015
Mailing Address - Street 1:17450 ST LUKES WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77384-8044
Mailing Address - Country:US
Mailing Address - Phone:281-203-5015
Mailing Address - Fax:936-271-2223
Practice Address - Street 1:17450 ST LUKES WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-8044
Practice Address - Country:US
Practice Address - Phone:281-203-5015
Practice Address - Fax:936-271-2223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80551237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty