Healthcare Provider Details

I. General information

NPI: 1912084302
Provider Name (Legal Business Name): REBECCA LYNN POWELL AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA LYNN FIELD AUD

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 12/02/2020
Certification Date: 12/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 COIT RD SUITE 120
PLANO TX
75075-5036
US

IV. Provider business mailing address

750 N COMMONS DR STE 200
AURORA IL
60504-7940
US

V. Phone/Fax

Practice location:
  • Phone: 972-519-8490
  • Fax: 972-758-5326
Mailing address:
  • Phone: 630-303-5380
  • Fax: 630-303-5385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number80412
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number80412
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: