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General NPI Number Information
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NPI Number | 1376742965
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Entity Type | Organization
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Legal Business Name | MIRACLE EAR- TEXAS, INC
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Dates
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Enumeration Date | 07/13/2007
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Last Update Date | 04/18/2014
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Provider Practice Location Address
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Address Line | 4522 SUMMERHILL RD
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City | TEXARKANA
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State | TX
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Zip | 75503-2740
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Country | US
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Telephone | 903-838-3093
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Fax |
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Provider Business Mailing Address
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Address Line | 5000 CHESHIRE LN N
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City | PLYMOUTH
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State | MN
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Zip | 55446-3706
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Country | US
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Telephone | 888-333-9152
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Fax | 763-268-4240
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | PAUL M D'AMICO
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Credential |
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Telephone | 888-333-9152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number |
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License Number State |
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