Healthcare Provider Details
I. General information
NPI: 1114247368
Provider Name (Legal Business Name): SYKOTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/09/2010
Last Update Date: 08/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13155 NOEL RD STE 900
DALLAS TX
75240-5090
US
IV. Provider business mailing address
2965 ROLLING HILLS LN
APOPKA FL
32712-6479
US
V. Phone/Fax
- Phone: 972-918-5144
- Fax: 972-918-5145
- Phone: 972-918-5144
- Fax: 972-918-5145
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 237700000X |
| Taxonomy | Hearing Instrument Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PEGGY
I
EARLY
Title or Position: PROVIDER/OWNER
Credential: NBCHIS
Phone: 972-918-5144