Healthcare Provider Details

I. General information

NPI: 1841354644
Provider Name (Legal Business Name): LAURIE KAY BORNSTEIN MS, CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 04/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5068 W PLANO PKWY STE 300
PLANO TX
75093-4408
US

IV. Provider business mailing address

5068 W PLANO PKWY STE 300
PLANO TX
75093-4408
US

V. Phone/Fax

Practice location:
  • Phone: 972-447-8330
  • Fax: 972-381-4201
Mailing address:
  • Phone: 972-447-8330
  • Fax: 972-381-4201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number51344
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number51344
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: