Provider Demographics
NPI:1619427754
Name:ATLAS AUDIOLOGY PLLC
Entity Type:Organization
Organization Name:ATLAS AUDIOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:806-224-1755
Mailing Address - Street 1:4702 67TH ST
Mailing Address - Street 2:STE A
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79414-5004
Mailing Address - Country:US
Mailing Address - Phone:806-224-1755
Mailing Address - Fax:806-224-1674
Practice Address - Street 1:4702 67TH ST
Practice Address - Street 2:STE A
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79414-5004
Practice Address - Country:US
Practice Address - Phone:806-224-1755
Practice Address - Fax:806-224-1674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-13
Last Update Date:2017-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty