Healthcare Provider Details

I. General information

NPI: 1932244217
Provider Name (Legal Business Name): JOHN R. EVERETT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 06/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 DALLAS DR SUITE 6
DENTON TX
76205-5100
US

IV. Provider business mailing address

1121 DALLAS DR SUITE 6
DENTON TX
76205-5100
US

V. Phone/Fax

Practice location:
  • Phone: 940-387-2195
  • Fax: 940-565-5973
Mailing address:
  • Phone:
  • Fax:

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: MARGIT E WALLACE
Title or Position: SECRETARY
Credential:
Phone: 940-387-2195