Provider Demographics
NPI:1679864649
Name:TEXAS THERAPEUTIC HEARING CARE CENTER, LLC
Entity Type:Organization
Organization Name:TEXAS THERAPEUTIC HEARING CARE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:D
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:903-758-8842
Mailing Address - Street 1:822 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-5433
Mailing Address - Country:US
Mailing Address - Phone:903-758-8842
Mailing Address - Fax:903-758-8877
Practice Address - Street 1:822 N 4TH ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-5433
Practice Address - Country:US
Practice Address - Phone:903-758-8842
Practice Address - Fax:903-758-8877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-26
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80409237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty