Provider Demographics
NPI:1952146631
Name:J. L. MIGUEZ, INC.
Entity type:Organization
Organization Name:J. L. MIGUEZ, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:DEANNE
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:903-567-0028
Mailing Address - Street 1:2230 W. GRANDE BLVD.,, SUITE 100
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703
Mailing Address - Country:US
Mailing Address - Phone:903-561-9992
Mailing Address - Fax:903-561-9277
Practice Address - Street 1:117 W. SABINE STREET, SUITE 4
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:TX
Practice Address - Zip Code:75633
Practice Address - Country:US
Practice Address - Phone:430-259-2192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:J.L. MIGUEZ, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty