Provider Demographics
NPI:1851700702
Name:MEMORIAL HEARING, PLLC
Entity Type:Organization
Organization Name:MEMORIAL HEARING, PLLC
Other - Org Name:MEMORIAL HEARING
Other - Org Type:Other Name
Authorized Official - Title/Position:AUDIOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:POURASEF
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:713-984-7562
Mailing Address - Street 1:908 TOWN AND COUNTRY BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2208
Mailing Address - Country:US
Mailing Address - Phone:713-984-7562
Mailing Address - Fax:
Practice Address - Street 1:908 TOWN AND COUNTRY BLVD STE 120
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2208
Practice Address - Country:US
Practice Address - Phone:713-984-7562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80074261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1396916706OtherNPI