Provider Demographics
NPI:1699812586
Name:WARD, LANA BRACKEN (AUD)
Entity Type:Individual
Prefix:DR
First Name:LANA
Middle Name:BRACKEN
Last Name:WARD
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:981 ATWOOD CT
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76049-1156
Mailing Address - Country:US
Mailing Address - Phone:940-369-7636
Mailing Address - Fax:940-369-7702
Practice Address - Street 1:907 W. SYCAMORE
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76203
Practice Address - Country:US
Practice Address - Phone:940-369-7636
Practice Address - Fax:940-369-7702
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50790231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist