Provider Demographics
NPI:1912194853
Name:DURBIN, ALAN WAYNE (AUDIOPROSTHOLOGIST)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:WAYNE
Last Name:DURBIN
Suffix:
Gender:M
Credentials:AUDIOPROSTHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 WILLOW RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-7242
Mailing Address - Country:US
Mailing Address - Phone:214-683-5817
Mailing Address - Fax:
Practice Address - Street 1:652 WILLOW RIDGE CIR
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-7242
Practice Address - Country:US
Practice Address - Phone:214-683-5817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50377237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist