Provider Demographics
NPI:1356596472
Name:HERITAGE HEARING CENTERS OF TEXAS
Entity type:Organization
Organization Name:HERITAGE HEARING CENTERS OF TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:GUERRA
Authorized Official - Suffix:JR
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:254-773-3335
Mailing Address - Street 1:1500 S 31ST ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-6752
Mailing Address - Country:US
Mailing Address - Phone:254-773-3335
Mailing Address - Fax:254-773-5333
Practice Address - Street 1:1500 S 31ST ST
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-6752
Practice Address - Country:US
Practice Address - Phone:254-773-3335
Practice Address - Fax:254-773-5333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50041237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty