Provider Demographics
NPI:1629102447
Name:EL PASO HEARING AID CENTER, INC
Entity Type:Organization
Organization Name:EL PASO HEARING AID CENTER, INC
Other - Org Name:SOUTHWEST HEARING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:PADILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-437-3708
Mailing Address - Street 1:1211 10TH ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-5832
Mailing Address - Country:US
Mailing Address - Phone:575-437-3708
Mailing Address - Fax:
Practice Address - Street 1:1211 10TH ST
Practice Address - Street 2:SUITE 3
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-5832
Practice Address - Country:US
Practice Address - Phone:505-437-3708
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3138237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMZ1925Medicaid