Healthcare Provider Details

I. General information

NPI: 1982331948
Provider Name (Legal Business Name): HANNAH GRACE MACH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2022
Last Update Date: 08/01/2022
Certification Date: 08/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8222 DOUGLAS AVE STE 815
DALLAS TX
75225-5900
US

IV. Provider business mailing address

405 CRAWFORD ST APT 2423
FORT WORTH TX
76104-1408
US

V. Phone/Fax

Practice location:
  • Phone: 214-360-9331
  • Fax:
Mailing address:
  • Phone: 254-722-6752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number81047
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: