Provider Demographics
NPI:1255512224
Name:HAUN, GARY A (AUDIOPROSTHOLOGIST)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:A
Last Name:HAUN
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 1:4335 COLLEGE HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904
Mailing Address - Country:US
Mailing Address - Phone:325-949-8351
Mailing Address - Fax:325-944-2958
Practice Address - Street 1:4335 COLLEGE HILLS BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76904
Practice Address - Country:US
Practice Address - Phone:325-949-8351
Practice Address - Fax:325-944-2958
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50278237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist