Provider Demographics
NPI:1932562048
Name:BEATTY AUDIOLOGY AND HEARING AIDS
Entity Type:Organization
Organization Name:BEATTY AUDIOLOGY AND HEARING AIDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:W
Authorized Official - Last Name:BEATTY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MA
Authorized Official - Phone:903-736-7358
Mailing Address - Street 1:102 TERESE DR
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-6156
Mailing Address - Country:US
Mailing Address - Phone:903-736-7358
Mailing Address - Fax:903-757-6052
Practice Address - Street 1:903 N 4TH ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-5416
Practice Address - Country:US
Practice Address - Phone:903-757-4083
Practice Address - Fax:903-757-6052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-05
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment