Provider Demographics
NPI:1750466157
Name:HEDRICK, MARK WILLIAM (AUD, CCC-A)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:WILLIAM
Last Name:HEDRICK
Suffix:
Gender:M
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10760 FM 2813 STE 100
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:TX
Mailing Address - Zip Code:75762-3732
Mailing Address - Country:US
Mailing Address - Phone:903-630-1501
Mailing Address - Fax:903-347-2468
Practice Address - Street 1:10760 FM 2813 STE 100
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:TX
Practice Address - Zip Code:75762-3732
Practice Address - Country:US
Practice Address - Phone:903-630-1501
Practice Address - Fax:903-347-2468
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80989231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist