Healthcare Provider Details

I. General information

NPI: 1467642819
Provider Name (Legal Business Name): UNCLE PERRY'S LLC, DBA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2007
Last Update Date: 03/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142A TRULY PLZ
CLEVELAND TX
77327-4889
US

IV. Provider business mailing address

142A TRULY PLZ
CLEVELAND TX
77327-4889
US

V. Phone/Fax

Practice location:
  • Phone: 281-659-2949
  • Fax: 281-659-1509
Mailing address:
  • Phone: 281-659-2949
  • Fax: 281-659-1509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN P SIMPSON
Title or Position: OWNER
Credential:
Phone: 281-659-2949