Provider Demographics
NPI:1427191014
Name:DCLC ENTERPRISES, LLC
Entity Type:Organization
Organization Name:DCLC ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:FITTING AND DISPENSE
Authorized Official - Phone:512-260-2665
Mailing Address - Street 1:601 WHITESTONE BLVD
Mailing Address - Street 2:SUITE 712
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613
Mailing Address - Country:US
Mailing Address - Phone:512-260-2665
Mailing Address - Fax:512-260-2668
Practice Address - Street 1:601 WHITESTONE BLVD
Practice Address - Street 2:SUITE 712
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613
Practice Address - Country:US
Practice Address - Phone:512-260-2665
Practice Address - Fax:512-260-2668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50961231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00X581Medicare PIN