Provider Demographics
NPI:1508003245
Name:TEXAS STATE HEARING, INC.
Entity Type:Organization
Organization Name:TEXAS STATE HEARING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:D
Authorized Official - Last Name:BRENNER
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:325-695-1133
Mailing Address - Street 1:598 S PIONEER DR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-2786
Mailing Address - Country:US
Mailing Address - Phone:325-695-1133
Mailing Address - Fax:325-695-4448
Practice Address - Street 1:598 S PIONEER DR
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-2786
Practice Address - Country:US
Practice Address - Phone:325-695-1133
Practice Address - Fax:325-695-4448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50059237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty