Healthcare Provider Details

I. General information

NPI: 1538872833
Provider Name (Legal Business Name): HBCA TEXAS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2023
Last Update Date: 01/02/2023
Certification Date: 01/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 WILLOW CREEK DR STE 105
WEATHERFORD TX
76085-3652
US

IV. Provider business mailing address

150 WILLOW CREEK DR STE 105
WEATHERFORD TX
76085-3652
US

V. Phone/Fax

Practice location:
  • Phone: 817-550-6115
  • Fax: 866-358-6404
Mailing address:
  • Phone: 817-550-6115
  • Fax: 866-358-6404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. BELIA GULLICKSON
Title or Position: BILLING MANAGER
Credential:
Phone: 817-253-0937