Provider Demographics
NPI:1437271988
Name:C&P WALLIS, INC
Entity Type:Organization
Organization Name:C&P WALLIS, INC
Other - Org Name:BELTONE HEARING AID SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUDIOPROSTHOLOGIST, VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:WALLIS
Authorized Official - Suffix:
Authorized Official - Credentials:ACA, NBC-HIS
Authorized Official - Phone:432-332-0519
Mailing Address - Street 1:817 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-4612
Mailing Address - Country:US
Mailing Address - Phone:432-332-0519
Mailing Address - Fax:432-337-7787
Practice Address - Street 1:817 E 7TH ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4612
Practice Address - Country:US
Practice Address - Phone:432-332-0519
Practice Address - Fax:432-337-7787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50079332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment