Healthcare Provider Details

I. General information

NPI: 1811399884
Provider Name (Legal Business Name): MIRACLE EAR CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2014
Last Update Date: 06/21/2023
Certification Date: 06/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8215 UNIVERSITY AVE STE 100
LUBBOCK TX
79423
US

IV. Provider business mailing address

8300 CENTRAL PARK DR STE 100
WACO TX
76712-6666
US

V. Phone/Fax

Practice location:
  • Phone: 806-698-1083
  • Fax:
Mailing address:
  • Phone: 254-227-5189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: KRISTIN BEHELER
Title or Position: STAFF ACCOUNTANT
Credential:
Phone: 254-227-5189