Provider Demographics
NPI:1962660027
Name:NOONAN, CHRISTOPHER B
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:B
Last Name:NOONAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 MCGUGAN LN
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-3524
Mailing Address - Country:US
Mailing Address - Phone:512-348-2149
Mailing Address - Fax:
Practice Address - Street 1:595 ROUND ROCK WEST DR
Practice Address - Street 2:SUITE 102
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-5011
Practice Address - Country:US
Practice Address - Phone:512-348-2149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80279237700000X
332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No332S00000XSuppliersHearing Aid Equipment