Provider Demographics
NPI:1568621605
Name:GATLIN, STEVEN BEAU (AUD)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:BEAU
Last Name:GATLIN
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2679
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78299
Mailing Address - Country:US
Mailing Address - Phone:210-616-0121
Mailing Address - Fax:210-614-1003
Practice Address - Street 1:19026 STONE OAK PARKWAY
Practice Address - Street 2:SUITE 110
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258
Practice Address - Country:US
Practice Address - Phone:210-545-0404
Practice Address - Fax:210-614-1003
Is Sole Proprietor?:No
Enumeration Date:2008-06-04
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80145237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter