Healthcare Provider Details

I. General information

NPI: 1558777573
Provider Name (Legal Business Name): MCLEAN HEARINGCENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2014
Last Update Date: 07/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6160 SHERRY LN STE 100
DALLAS TX
75225-6314
US

IV. Provider business mailing address

6160 SHERRY LN STE 100
DALLAS TX
75225-6314
US

V. Phone/Fax

Practice location:
  • Phone: 214-363-4955
  • Fax: 214-363-4970
Mailing address:
  • Phone: 214-363-4955
  • Fax: 214-363-4970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number50578
License Number StateTX

VIII. Authorized Official

Name: MRS. ANGLEA MCLEAN
Title or Position: OWNER
Credential:
Phone: 214-363-4955