Provider Demographics
NPI:1750858445
Name:CLARK HEARING, INC
Entity Type:Organization
Organization Name:CLARK HEARING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:281-789-4875
Mailing Address - Street 1:PO BOX 1464
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-1464
Mailing Address - Country:US
Mailing Address - Phone:281-789-4874
Mailing Address - Fax:832-479-2286
Practice Address - Street 1:32731 EGYPT LN STE 701
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-3663
Practice Address - Country:US
Practice Address - Phone:281-789-4875
Practice Address - Fax:832-479-2286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-31
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX557323575OtherBCBS