Provider Demographics
NPI:1801375795
Name:ALLISON AUDIOLOGY & HEARING AID CENTER - LAKE JACKSON, P.C.
Entity Type:Organization
Organization Name:ALLISON AUDIOLOGY & HEARING AID CENTER - LAKE JACKSON, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANA
Authorized Official - Middle Name:
Authorized Official - Last Name:EMOLA-AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:979-292-8501
Mailing Address - Street 1:104 CIRCLE WAY ST STE D
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-5200
Mailing Address - Country:US
Mailing Address - Phone:979-292-8501
Mailing Address - Fax:979-292-8505
Practice Address - Street 1:104 CIRCLE WAY ST STE D
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-5200
Practice Address - Country:US
Practice Address - Phone:979-292-8501
Practice Address - Fax:979-292-8505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-10
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80140231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty