=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134269780
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ORLAND PURCELL AUD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/06/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2101 N MIDLAND DR STE 4
-----------------------------------------------------
City | MIDLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79707-5593
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 432-689-4327
-----------------------------------------------------
Fax | 432-689-4329
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2101 N MIDLAND DR STE 4
-----------------------------------------------------
City | MIDLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79707-5593
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 432-689-4327
-----------------------------------------------------
Fax | 432-689-4329
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 231H00000X
-----------------------------------------------------
Taxonomy Name | Audiologist
-----------------------------------------------------
License Number | 50480
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------