Healthcare Provider Details

I. General information

NPI: 1508215625
Provider Name (Legal Business Name): NORTHLAND HEARING CENTERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2016
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 LOHMANS CROSSING RD STE 502
LAKEWAY TX
78734-5288
US

IV. Provider business mailing address

6700 WASHINGTON AVE S
EDEN PRAIRIE MN
55344-3405
US

V. Phone/Fax

Practice location:
  • Phone: 512-263-2176
  • Fax: 512-263-8990
Mailing address:
  • Phone: 800-328-8602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BEE XIONG
Title or Position: MANAGER OF REVENUE CYCLE
Credential:
Phone: 952-995-6601