| Grapevine Audiology | |
|
190 S Peytonville Ave Ste 120, Southlake, TX 76092-6937 | |
| (817) 488-1637 | |
| (817) 488-2854 |
| Full Name | Grapevine Audiology |
|---|---|
| Type | Facility |
| Speciality | Audiologist |
| Location | 190 S Peytonville Ave Ste 120, Southlake, Texas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891815759 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 231H00000X | Audiologist | 51647 (Texas) | Primary |
| Provider Name | Tara L Wheeler |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1003936949 PECOS PAC ID: 3779667522 Enrollment ID: I20090403000269 |
| Provider Name | Carmen Laine Pustejovsky |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1144668682 PECOS PAC ID: 4284861493 Enrollment ID: I20131216000050 |
| Provider Name | Brittani Allyn Brooks |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1912746421 PECOS PAC ID: 4284176041 Enrollment ID: I20240607001163 |
| Mailing Address | Practice Location Address |
|---|---|
| Grapevine Audiology 190 S Peytonville Ave Ste 120, Southlake, TX 76092-6937 Ph: (817) 488-1637 | Grapevine Audiology 190 S Peytonville Ave Ste 120, Southlake, TX 76092-6937 Ph: (817) 488-1637 |
Kathryn Cassidy, Audiologist Medicare: Not Enrolled in Medicare Practice Location: 190 S Peytonville Ave Ste 120, Southlake, TX 76092 Phone: 817-488-1637 | |
Grace Paddock, AUD Audiologist Medicare: Medicare Enrolled Practice Location: 1438 E Southlake Blvd, Southlake, TX 76092 Phone: 682-477-4063 Fax: 682-477-4000 | |
Mary Maddie Pollok, AUD FAAA Audiologist Medicare: Accepting Medicare Assignments Practice Location: 245 W State Highway 114 Ste 120, Southlake, TX 76092 Phone: 817-591-7155 | |
Ashley Brown, AUD Audiologist Medicare: Not Enrolled in Medicare Practice Location: 190 S Peytonville Ave Ste 120, Southlake, TX 76092 Phone: 817-488-1637 | |
Dr. Lori Amber Roby, AUD Audiologist Medicare: Accepting Medicare Assignments Practice Location: 2211 E Southlake Blvd Ste 525, Southlake, TX 76092 Phone: 817-873-6810 | |
Courtney Cron, AUD Audiologist Medicare: Medicare Enrolled Practice Location: 2813 W Southlake Blvd Ste 150, Southlake, TX 76092 Phone: 817-835-9289 | |
Dr. Kristen Moriah Crawford, AUD Audiologist Medicare: Accepting Medicare Assignments Practice Location: 300 S Nolen Dr, Southlake, TX 76092 Phone: 817-989-2400 |