Healthcare Provider Details

I. General information

NPI: 1659513703
Provider Name (Legal Business Name): SOUTHWEST INSTITUTE OF HEARING AND BALANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2009
Last Update Date: 04/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 S TELSHOR BLVD
LAS CRUCES NM
88011-5049
US

IV. Provider business mailing address

2415 S TELSHOR BLVD
LAS CRUCES NM
88011-5049
US

V. Phone/Fax

Practice location:
  • Phone: 575-532-5225
  • Fax: 575-522-0930
Mailing address:
  • Phone: 575-532-5225
  • Fax: 575-522-0930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number1432
License Number StateNM

VIII. Authorized Official

Name: DR. SUNIL T PAI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 575-649-2196