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General NPI Number Information
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NPI Number | 1215475595
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Entity Type | Organization
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Legal Business Name | BIONIX HEARING, LLC
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Dates
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Enumeration Date | 02/07/2017
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Last Update Date | 08/21/2018
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Provider Practice Location Address
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Address Line | 2217 NORTH TARRANT PKWY #211
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City | FORT WORTH
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State | TX
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Zip | 76177-2220
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Country | US
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Telephone | 972-922-7456
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Fax | 972-922-7104
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Provider Business Mailing Address
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Address Line | 2217 NORTH TARRANT PKWY #211
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City | FORT WORTH
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State | TX
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Zip | 76177-2220
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Country | US
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Telephone | 972-922-7456
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Fax | 972-922-7104
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Authorized Official
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Title or Position | OWNER
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Name | MR. CARL EDWARDS
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Credential | H.I.S.
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Telephone | 972-922-7456
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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 | 50644
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License Number State | TX
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