MEDICARE: HEARING AID LABS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332S00000X	Hearing Aid Equipment	50204	TX

General Provider Information

NPI Number	:	1134390438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARING AID LABS LLC

Provider Business Mailing Address
First Line	:	1931 NW MILITARY HWY
Second Line	:	SUITE 100
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-2153
Country	:	US
Telephone Number	:	210-342-3924
Fax Number	:	210-342-6176

Provider Business Practice Location Address
First Line	:	1931 NW MILITARY HWY
Second Line	:	SUITE 100
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-2153
Country	:	US
Telephone Number	:	210-342-3924
Fax Number	:	210-342-6176

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RALPH RENE CANALES JR.
Credential	:
Telephone Number	:	210-342-3924

Provider Enumeration Date	:	03/14/2008
Last Update Date	:	03/14/2008

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