Healthcare Provider Details

I. General information

NPI: 1861214926
Provider Name (Legal Business Name): HEARING AID INNOVATIONS AR, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2024
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 E COLLIN RAYE DR
DE QUEEN AR
71832-8054
US

IV. Provider business mailing address

103 W ALAMO ST
BRENHAM TX
77833-3627
US

V. Phone/Fax

Practice location:
  • Phone: 870-642-3211
  • Fax:
Mailing address:
  • Phone: 979-830-0865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. AARON GONZALEZ
Title or Position: HEARING INSTRUMENT SPECIALIST
Credential:
Phone: 979-830-0865