Provider Demographics
NPI:1891124582
Name:WOOSTER, JOHN ARTHUR I (HIS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ARTHUR
Last Name:WOOSTER
Suffix:I
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3605 N.E.LOOP 286
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-4980
Mailing Address - Country:US
Mailing Address - Phone:903-739-8898
Mailing Address - Fax:
Practice Address - Street 1:3605 NE LOOP 286
Practice Address - Street 2:SUITE 100
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-5000
Practice Address - Country:US
Practice Address - Phone:903-739-8898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50667237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist