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General NPI Number Information
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NPI Number | 1245486257
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Entity Type | Organization
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Legal Business Name | THE HEARING GROUP OF NEW MEXICO, LLC
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Dates
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Enumeration Date | 08/09/2008
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 2060 MAIN ST NE STE A
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City | LOS LUNAS
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State | NM
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Zip | 87031-6368
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Country | US
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Telephone | 505-247-4466
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Fax | 505-247-4472
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Provider Business Mailing Address
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Address Line | 2060 MAIN ST NE STE A
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City | LOS LUNAS
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State | NM
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Zip | 87031-6368
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Country | US
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Telephone | 505-247-4466
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Fax | 505-796-4722
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Authorized Official
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Title or Position | OWNER/AUDIOLOGIST
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Name | MR. JOSE R. CORREA
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Credential | MS CCC-A
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Telephone | 505-247-4466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 3541
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License Number State | NM
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