Provider Demographics
NPI:1982890075
Name:ENTERPRISE HEARING CENTERS INC
Entity Type:Organization
Organization Name:ENTERPRISE HEARING CENTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:BC HIS ACA
Authorized Official - Phone:505-622-2887
Mailing Address - Street 1:PO BOX 4283
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88202
Mailing Address - Country:US
Mailing Address - Phone:505-622-2887
Mailing Address - Fax:505-622-3379
Practice Address - Street 1:4410 N. MIDKIFF RD.
Practice Address - Street 2:SUITE D-4
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705
Practice Address - Country:US
Practice Address - Phone:432-689-3078
Practice Address - Fax:505-622-3379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50651231H00000X
NM470A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty