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General NPI Number Information
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NPI Number | 1376065615
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Entity Type | Organization
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Legal Business Name | SCOUT AUDIOLOGY, PLLC
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Dates
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Enumeration Date | 07/07/2017
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Last Update Date | 06/01/2018
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Provider Practice Location Address
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Address Line | 3616 FAR WEST BLVD STE 117-401
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City | AUSTIN
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State | TX
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Zip | 78731
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Country | US
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Telephone | 972-953-8914
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Fax |
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Provider Business Mailing Address
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Address Line | 3616 FAR WEST BLVD STE 117-401
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City | AUSTIN
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State | TX
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Zip | 78731-3082
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Country | US
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Telephone | 512-666-1945
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF AUDIOLOGY
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Name | DR. KELLY MARIE POWELL
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Credential | AU.D.
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Telephone | 972-953-8914
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | 80543
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License Number State | TX
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