MEDICARE: BEAU T ENGLAND AU.D.

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	237600000X	Audiologist-Hearing Aid Fitter	A-242	NV
2	231H00000X	Audiologist	A-242	NV

General Provider Information

NPI Number	:	1972865996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEAU T ENGLAND AU.D.

Provider Business Mailing Address
First Line	:	10470 W CHEYENNE AVE STE 120
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-8733
Country	:	US
Telephone Number	:	702-240-2059
Fax Number	:	702-240-2065

Provider Business Practice Location Address
First Line	:	5920 S RAINBOW BLVD
Second Line	:	SUITE 9
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-4208
Country	:	US
Telephone Number	:	702-362-3138
Fax Number	:

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

Provider Enumeration Date	:	06/14/2012
Last Update Date	:	12/23/2020

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