Provider Demographics
NPI:1942460894
Name:PROFESSIONAL HEARING SERVICES PLLC
Entity Type:Organization
Organization Name:PROFESSIONAL HEARING SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JODY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SEALS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:903-748-6864
Mailing Address - Street 1:2011 MALL DR STE 4
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-2550
Mailing Address - Country:US
Mailing Address - Phone:903-748-6864
Mailing Address - Fax:903-792-3985
Practice Address - Street 1:2011 MALL DR STE 4
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-2550
Practice Address - Country:US
Practice Address - Phone:903-792-3986
Practice Address - Fax:903-792-3935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50509231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty