Provider Demographics
NPI:1467608166
Name:AUDIOLOGICAL SERVICES OF ELLIS COUNTY
Entity Type:Organization
Organization Name:AUDIOLOGICAL SERVICES OF ELLIS COUNTY
Other - Org Name:THE HEARING CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:DOCTOR OF AUDIOLOGY
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:CHENEY
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:972-723-6181
Mailing Address - Street 1:1000 E MAIN ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-3337
Mailing Address - Country:US
Mailing Address - Phone:972-723-6181
Mailing Address - Fax:972-723-1230
Practice Address - Street 1:1000 E MAIN ST
Practice Address - Street 2:SUITE 303
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-3337
Practice Address - Country:US
Practice Address - Phone:972-723-6181
Practice Address - Fax:972-723-1230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50730231H00000X, 231HA2400X, 231HA2500X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology PractitionerGroup - Multi-Specialty
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology SupplierGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty