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General NPI Number Information
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NPI Number | 1093056731
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Entity Type | Individual
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Provider Name | JOHN LESLIE BEDINGHAUS LICENSED DISPENSER
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Gender | Male
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Dates
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Enumeration Date | 03/05/2013
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Last Update Date | 03/05/2013
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Provider Practice Location Address
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Address Line | 200 N 15TH ST SUITE 11
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City | CORSICANA
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State | TX
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Zip | 75110-4536
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Country | US
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Telephone | 903-872-6333
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Fax | 903-872-3210
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Provider Business Mailing Address
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Address Line | 200 N 15TH ST SUITE 11
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City | CORSICANA
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State | TX
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Zip | 75110-4536
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Country | US
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Telephone | 903-872-6333
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Fax | 903-872-3210
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 80324
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License Number State | TX
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