Provider Demographics
NPI:1518109370
Name:OSWALD, MIKKI
Entity Type:Individual
Prefix:
First Name:MIKKI
Middle Name:
Last Name:OSWALD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 I 45 S SUITE 400
Mailing Address - Street 2:C/O MIRACLE EAR
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340
Mailing Address - Country:US
Mailing Address - Phone:936-755-8123
Mailing Address - Fax:
Practice Address - Street 1:921 FM 1960 RD W
Practice Address - Street 2:#101-B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2505
Practice Address - Country:US
Practice Address - Phone:281-397-7232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-25
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80329237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist