Provider Demographics
NPI:1740875004
Name:ADVANCED HEARING AID TECHNOLOGY OF AMARILLO. LLC
Entity type:Organization
Organization Name:ADVANCED HEARING AID TECHNOLOGY OF AMARILLO. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HOCKADAY
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:806-355-9957
Mailing Address - Street 1:3505 OLSEN BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-3035
Mailing Address - Country:US
Mailing Address - Phone:806-355-9957
Mailing Address - Fax:806-353-1235
Practice Address - Street 1:3505 OLSEN BLVD STE 108
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-3035
Practice Address - Country:US
Practice Address - Phone:806-355-9957
Practice Address - Fax:806-353-1235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80975OtherHEARING INSTRUMENT FITTER AND DISPENSER LICENSE