Provider Demographics
NPI:1245540723
Name:AUDIOLOGY PROVIDERS, P.C.
Entity type:Organization
Organization Name:AUDIOLOGY PROVIDERS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF AUDIOLOGY
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:WEBB
Authorized Official - Last Name:HOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD, CCC-A
Authorized Official - Phone:214-705-9994
Mailing Address - Street 1:7000 PARKWOOD BLVD STE G100
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-7621
Mailing Address - Country:US
Mailing Address - Phone:214-705-9994
Mailing Address - Fax:214-705-9996
Practice Address - Street 1:7589 PRESTON RD
Practice Address - Street 2:SUITE 300
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-5667
Practice Address - Country:US
Practice Address - Phone:214-705-9994
Practice Address - Fax:214-705-9996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB120084OtherMEDICARE GROUP PTAN
TXTXB120085OtherMEDICARE INDIVIDUAL PTAN