Healthcare Provider's Profile
Full Name | |
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Type | Facility |
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Speciality | Hearing Aid Equipment |
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Location | 3211 4th St Ste B, Longview, Texas |
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Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
NPI Data:
- NPI Number: 1093985046
- Provider Enumeration Date: 03/06/2008
- Last Update Date: 06/13/2023
Medical Identifiers
Medical identifiers for
such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1093985046 | NPI | - | NPPES |
112774802 | Medicaid | TX | |
0615164 | Other | TX | AETNA |
530294 | Other | TX | BCBS |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
231H00000X | Audiologist | (* (Not Available)) | Secondary |
237600000X | Audiologist-hearing Aid Fitter | (* (Not Available)) | Secondary |
237700000X | Hearing Instrument Specialist | (* (Not Available)) | Secondary |
332S00000X | Hearing Aid Equipment | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
750 N Commons Dr Ste 200, Aurora, IL 60504-7940 Ph: (630) 303-5380 | 3211 4th St Ste B, Longview, TX 75605-5145 Ph: (903) 758-8346 |
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