Healthcare Provider Details

I. General information

NPI: 1396563904
Provider Name (Legal Business Name): THE HEARING HAVEN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2024
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 MEDI PARK DR STE 2060
AMARILLO TX
79106-2110
US

IV. Provider business mailing address

1901 MEDI PARK DR STE 2060
AMARILLO TX
79106-2110
US

V. Phone/Fax

Practice location:
  • Phone: 806-414-8033
  • Fax:
Mailing address:
  • Phone: 806-414-8033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: EMILY M BRAUN
Title or Position: OWNER
Credential:
Phone: 806-414-8033