Provider Demographics
NPI:1740560895
Name:ADVANCED HEARING SOLUTIONS OF SOUTH TEXAS
Entity Type:Organization
Organization Name:ADVANCED HEARING SOLUTIONS OF SOUTH TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:HAAS
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:361-991-6222
Mailing Address - Street 1:3201 AIRLINE RD STE C
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-3571
Mailing Address - Country:US
Mailing Address - Phone:361-991-6222
Mailing Address - Fax:361-334-6666
Practice Address - Street 1:3201 AIRLINE RD STE C
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-3571
Practice Address - Country:US
Practice Address - Phone:361-991-6222
Practice Address - Fax:361-334-6666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-22
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80474237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1225126410OtherFACILITY