Healthcare Provider Details

I. General information

NPI: 1174886501
Provider Name (Legal Business Name): SUNRISE HEARING CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2012
Last Update Date: 06/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6955 N MESA ST 304C
EL PASO TX
79912-4442
US

IV. Provider business mailing address

PO BOX 60449
MIDLAND TX
79711-0449
US

V. Phone/Fax

Practice location:
  • Phone: 915-581-1640
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number80240
License Number StateTX

VIII. Authorized Official

Name: MICHAEL FAIN
Title or Position: PRESIDENT
Credential:
Phone: 432-563-8125