MEDICARE: LAURA CARPENTER

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	80280	TX

General Provider Information

NPI Number	:	1790938116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA CARPENTER

Provider Business Mailing Address
First Line	:	1387 BAT MASTERSON DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-7850
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2508 N GRANDVIEW AVE
Second Line	:
City	:	ODESSA
State	:	TX
Zip	:	79761-1606
Country	:	US
Telephone Number	:	432-368-7777
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2008
Last Update Date	:	10/29/2008

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Directions to “ LAURA CARPENTER ” Practice Location

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