Provider Demographics
NPI:1891019089
Name:PROFESSIONAL HEARING AID CENTER
Entity Type:Organization
Organization Name:PROFESSIONAL HEARING AID CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEARING AID SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMA-RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-858-4327
Mailing Address - Street 1:8981 CASTNER DR
Mailing Address - Street 2:STE F
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79907-1852
Mailing Address - Country:US
Mailing Address - Phone:915-858-4327
Mailing Address - Fax:915-858-0731
Practice Address - Street 1:8981 CASTNER DR
Practice Address - Street 2:STE F
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79907-1852
Practice Address - Country:US
Practice Address - Phone:915-858-4327
Practice Address - Fax:915-858-0731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50295332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1892101Medicaid