Provider Demographics
NPI:1578033320
Name:DRULEY, JOHN BRIAN (HIS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:BRIAN
Last Name:DRULEY
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 W PIKE BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-4708
Mailing Address - Country:US
Mailing Address - Phone:956-254-6519
Mailing Address - Fax:956-647-5157
Practice Address - Street 1:413 W PIKE BLVD STE B
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-4708
Practice Address - Country:US
Practice Address - Phone:956-254-6519
Practice Address - Fax:956-647-5157
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-04
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80741237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist