Healthcare Provider Details

I. General information

NPI: 1033481254
Provider Name (Legal Business Name): PHYSICIANS HEARING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2012
Last Update Date: 05/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 S SONCY RD 140
AMARILLO TX
79119
US

IV. Provider business mailing address

PO BOX 840026
DALLAS TX
75284-0026
US

V. Phone/Fax

Practice location:
  • Phone: 806-352-6901
  • Fax: 806-352-2245
Mailing address:
  • Phone: 806-212-6965
  • Fax: 806-212-6278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number51143
License Number StateTX

VIII. Authorized Official

Name: MR. BOB WILLIAMS
Title or Position: CEO
Credential:
Phone: 806-212-2000