Provider Demographics
NPI:1487022232
Name:FAMILY HEARING PRACTICE, PLLC
Entity Type:Organization
Organization Name:FAMILY HEARING PRACTICE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LIBERIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-997-4084
Mailing Address - Street 1:4491 LONG PRAIRIE RD STE 400
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1795
Mailing Address - Country:US
Mailing Address - Phone:817-997-4084
Mailing Address - Fax:817-333-1190
Practice Address - Street 1:4491 LONG PRAIRIE RD STE 400
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1795
Practice Address - Country:US
Practice Address - Phone:817-997-4084
Practice Address - Fax:817-333-1190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-10
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80297231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXOTH000Medicare UPIN