Provider Demographics
NPI:1124469713
Name:SPECIALTY HEARING LLC
Entity type:Organization
Organization Name:SPECIALTY HEARING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-627-7771
Mailing Address - Street 1:330 MAIN ST
Mailing Address - Street 2:STE 1C
Mailing Address - City:SEALY
Mailing Address - State:TX
Mailing Address - Zip Code:77474-2391
Mailing Address - Country:US
Mailing Address - Phone:979-627-7771
Mailing Address - Fax:979-627-7769
Practice Address - Street 1:330 MAIN ST
Practice Address - Street 2:STE 1C
Practice Address - City:SEALY
Practice Address - State:TX
Practice Address - Zip Code:77474-2391
Practice Address - Country:US
Practice Address - Phone:979-627-7771
Practice Address - Fax:979-627-7769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-11
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80371237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty