Provider Demographics
NPI:1700098662
Name:THE HEARING CENTER OF LAKE CHARLES, INC.
Entity Type:Organization
Organization Name:THE HEARING CENTER OF LAKE CHARLES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:RAMGOPAL
Authorized Official - Middle Name:S
Authorized Official - Last Name:NILESHWAR
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:337-474-3880
Mailing Address - Street 1:1919A SOUTHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-4132
Mailing Address - Country:US
Mailing Address - Phone:337-474-3880
Mailing Address - Fax:337-474-6890
Practice Address - Street 1:1919A SOUTHWOOD DR
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-4132
Practice Address - Country:US
Practice Address - Phone:337-474-3880
Practice Address - Fax:337-474-6890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5X788Medicare PIN