Healthcare Provider Details

I. General information

NPI: 1790041705
Provider Name (Legal Business Name): BETTER HEARING ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2012
Last Update Date: 02/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 W UNIVERSITY BLVD SUITE 114
DURANT OK
74701-3090
US

IV. Provider business mailing address

2828 W UNIVERSITY BLVD SUITE 114
DURANT OK
74701-3090
US

V. Phone/Fax

Practice location:
  • Phone: 580-745-5171
  • Fax: 580-745-5173
Mailing address:
  • Phone: 580-745-5171
  • Fax: 580-745-5173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number80077
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number80264
License Number StateTX

VIII. Authorized Official

Name: KELLY JOHNSON
Title or Position: OWNER/MEMBER
Credential: AUD
Phone: 580-745-5171