Provider Demographics
NPI:1710172424
Name:BELTONE HEARING CENTERS
Entity Type:Organization
Organization Name:BELTONE HEARING CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TY
Authorized Official - Middle Name:
Authorized Official - Last Name:MANUEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-892-9091
Mailing Address - Street 1:PO BOX 1526
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77631-1526
Mailing Address - Country:US
Mailing Address - Phone:409-892-9091
Mailing Address - Fax:409-892-9090
Practice Address - Street 1:4030 DOWLEN RD STE 6
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-6878
Practice Address - Country:US
Practice Address - Phone:409-892-9091
Practice Address - Fax:409-892-9090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50322332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX180555801Medicaid