Healthcare Provider Details

I. General information

NPI: 1427122704
Provider Name (Legal Business Name): JOE D CRNKOVIC DBA AUDIBLE HEARING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2305 CAVITT AVE
BRYAN TX
77801-2006
US

IV. Provider business mailing address

2305 CAVITT AVE
BRYAN TX
77801
US

V. Phone/Fax

Practice location:
  • Phone: 979-779-3070
  • Fax: 979-779-7565
Mailing address:
  • Phone: 979-779-3070
  • Fax: 979-779-7565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number50263
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: MR. JOE D CRNKOVIC
Title or Position: OWNER
Credential: ACA
Phone: 979-779-3070