Provider Demographics
NPI:1629262480
Name:MICRO HEARING AID CENTER
Entity Type:Organization
Organization Name:MICRO HEARING AID CENTER
Other - Org Name:JERRY D ILING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:ILLING
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:713-666-9880
Mailing Address - Street 1:6500 NEWCASTLE ST
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4314
Mailing Address - Country:US
Mailing Address - Phone:713-666-9880
Mailing Address - Fax:713-664-7035
Practice Address - Street 1:6500 NEWCASTLE ST
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4314
Practice Address - Country:US
Practice Address - Phone:713-666-9880
Practice Address - Fax:713-664-7035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50293332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment