Provider Demographics
NPI:1598255507
Name:WEST TEXAS AUDIOLOGY AND HEARING AID CENTER
Entity Type:Organization
Organization Name:WEST TEXAS AUDIOLOGY AND HEARING AID CENTER
Other - Org Name:THE HEARING DOCTO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARICA
Authorized Official - Middle Name:G
Authorized Official - Last Name:BLACK
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:806-798-3600
Mailing Address - Street 1:5607 114TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424
Mailing Address - Country:US
Mailing Address - Phone:806-798-3600
Mailing Address - Fax:
Practice Address - Street 1:5607 114TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424
Practice Address - Country:US
Practice Address - Phone:806-798-3600
Practice Address - Fax:806-798-3601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-15
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty