MEDICARE: ALLIED HEARING CARE CENTER 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	237700000X	Hearing Instrument Specialist	50531	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	532338	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1467580167
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIED HEARING CARE CENTER LLC

Provider Business Mailing Address
First Line	:	32 FM 1960 W
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-3530
Country	:	US
Telephone Number	:	281-397-8595
Fax Number	:	281-397-8584

Provider Business Practice Location Address
First Line	:	32 FM 1960 W
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-3530
Country	:	US
Telephone Number	:	281-397-8595
Fax Number	:	281-397-8584

Authorized Official
Title or Position	:	SPECIALIST LICENSED BY TEXAS
Name	:	MS. DIANE M LEDERER
Credential	:
Telephone Number	:	281-397-8595

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	08/22/2020

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