Healthcare Provider Details

I. General information

NPI: 1538563358
Provider Name (Legal Business Name): ACHIEVE HEARING & REHABILITATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2014
Last Update Date: 10/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5928 W PARKER RD STE 1000
PLANO TX
75093-6435
US

IV. Provider business mailing address

5928 W PARKER RD STE 1000
PLANO TX
75093-6435
US

V. Phone/Fax

Practice location:
  • Phone: 972-608-0416
  • Fax:
Mailing address:
  • Phone: 972-608-0416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number51347
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number51347
License Number StateTX

VIII. Authorized Official

Name: MICHAEL PETER GEHAN
Title or Position: OWNER
Credential: MS
Phone: 972-608-0416