Provider Demographics
NPI:1497945505
Name:JOHNSON, SYLVIA LARKIN (MS)
Entity Type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:LARKIN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 BALCONES DR
Mailing Address - Street 2:#200 HEARING AID AND IMPLANT CONSULTANTS
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731
Mailing Address - Country:US
Mailing Address - Phone:512-836-8786
Mailing Address - Fax:512-836-8794
Practice Address - Street 1:5750 BALCONES DR
Practice Address - Street 2:#200 HEARING AID AND IMPLANT CONSULTANTS
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731
Practice Address - Country:US
Practice Address - Phone:512-836-8786
Practice Address - Fax:512-836-8794
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50285237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80736AOtherBCBS - AENTC
TX80735AOtherBCBS - HCAENTC
TXTXB124551Medicare PIN