Provider Demographics
NPI:1578139184
Name:ECOUTEZ SOUTHLAKE LLC
Entity Type:Organization
Organization Name:ECOUTEZ SOUTHLAKE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:PADDOCK
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:847-770-0768
Mailing Address - Street 1:1438 E SOUTHLAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6419
Mailing Address - Country:US
Mailing Address - Phone:682-477-4063
Mailing Address - Fax:682-477-4000
Practice Address - Street 1:1438 E SOUTHLAKE BLVD
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6419
Practice Address - Country:US
Practice Address - Phone:682-477-4063
Practice Address - Fax:682-477-4000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-03
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology SupplierGroup - Single Specialty