Healthcare Provider Details

I. General information

NPI: 1629102447
Provider Name (Legal Business Name): EL PASO HEARING AID CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 11/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 10TH ST SUITE 3
ALAMOGORDO NM
88310-5832
US

IV. Provider business mailing address

1211 10TH ST SUITE 3
ALAMOGORDO NM
88310-5832
US

V. Phone/Fax

Practice location:
  • Phone: 505-437-3708
  • Fax:
Mailing address:
  • Phone: 575-437-3708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number3138
License Number StateNM

VIII. Authorized Official

Name: LIZ PADILLA
Title or Position: OFFICE MANAGER
Credential:
Phone: 575-437-3708