Provider Demographics
NPI:1821488206
Name:SCARBOROUGH HEARING AIDS
Entity Type:Organization
Organization Name:SCARBOROUGH HEARING AIDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:P
Authorized Official - Last Name:SCARBOROUGH
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:409-892-1222
Mailing Address - Street 1:1922 W SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77630-3306
Mailing Address - Country:US
Mailing Address - Phone:409-892-1222
Mailing Address - Fax:409-892-1861
Practice Address - Street 1:4349 CROW RD
Practice Address - Street 2:SUITE C
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-7082
Practice Address - Country:US
Practice Address - Phone:409-892-1222
Practice Address - Fax:409-892-1861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-23
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50397237700000X, 332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
No332S00000XSuppliersHearing Aid EquipmentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1801216445OtherINDIVIDUAL NPI