MEDICARE: WTHAC, INC

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
2	237700000X	Hearing Instrument Specialist

General Provider Information

NPI Number	:	1962687723
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WTHAC, INC

Provider Business Mailing Address
First Line	:	1387 BAT MASTERSON DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-7850
Country	:	US
Telephone Number	:	915-860-1593
Fax Number	:	915-860-1593

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	:	432-363-4327

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LAURA F CARPENTER
Credential	:
Telephone Number	:	915-860-1593

Provider Enumeration Date	:	12/28/2007
Last Update Date	:	10/10/2008

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Directions to “WTHAC, INC ” Practice Location

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