Provider Demographics
NPI: | 1629306683 |
---|---|
Name: | MEMORIAL NORTHWEST HEARING AIDS, LLC |
Entity Type: | Organization |
Organization Name: | MEMORIAL NORTHWEST HEARING AIDS, LLC |
Other - Org Name: | MEM NW HEARING AIDS, LLC |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | ADMINISTRATOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DON |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | UNFRIED |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 713-802-9779 |
Mailing Address - Street 1: | 1740 W 27TH ST |
Mailing Address - Street 2: | SUITE 234 |
Mailing Address - City: | HOUSTON |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 77008-1440 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 713-802-9779 |
Mailing Address - Fax: | 713-802-2289 |
Practice Address - Street 1: | 1740 W 27TH ST |
Practice Address - Street 2: | SUITE 234 |
Practice Address - City: | HOUSTON |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77008-1440 |
Practice Address - Country: | US |
Practice Address - Phone: | 713-802-9779 |
Practice Address - Fax: | 713-802-2289 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-12-01 |
Last Update Date: | 2009-12-01 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QH0700X | Ambulatory Health Care Facilities | Clinic/Center | Hearing and Speech |