Provider Demographics
NPI:1811447279
Name:JL MIGUEZ INCORPORATED
Entity type:Organization
Organization Name:JL MIGUEZ INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:MIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:903-561-9992
Mailing Address - Street 1:150 E DALLAS ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:TX
Mailing Address - Zip Code:75103-1425
Mailing Address - Country:US
Mailing Address - Phone:903-567-0028
Mailing Address - Fax:903-567-0029
Practice Address - Street 1:150 E DALLAS ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:TX
Practice Address - Zip Code:75103-1425
Practice Address - Country:US
Practice Address - Phone:903-567-0028
Practice Address - Fax:903-567-0029
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JL MIGUEZ INCORPORATED HEAR LIFE HEARING CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50216332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment