Healthcare Provider Details

I. General information

NPI: 1841630860
Provider Name (Legal Business Name): BROOKS HEARING,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2013
Last Update Date: 07/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W 19TH ST
MT PLEASANT TX
75455-2322
US

IV. Provider business mailing address

3130 LAMAR AVE
PARIS TX
75460-5020
US

V. Phone/Fax

Practice location:
  • Phone: 903-737-8800
  • Fax: 903-784-8429
Mailing address:
  • Phone: 903-737-8800
  • Fax: 903-784-8429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number50734
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14561
License Number StateTX

VIII. Authorized Official

Name: JAMI H BROOKS
Title or Position: AUDIOLOGIST/SPEECH PATHOLOGIST
Credential: AUD.,CCC A/SLP
Phone: 903-737-8800