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General NPI Number Information
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NPI Number | 1447663364
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Entity Type | Organization
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Legal Business Name | SIGNATURE HEARING & BALANCE, PLLC
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Dates
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Enumeration Date | 06/09/2014
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Last Update Date | 08/17/2023
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Provider Practice Location Address
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Address Line | 1856 FM 359 RD
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City | RICHMOND
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State | TX
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Zip | 77406-1296
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Country | US
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Telephone | 979-250-1335
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Fax |
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Provider Business Mailing Address
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Address Line | 1860 FM 359 RD #324
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City | RICHMOND
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State | TX
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Zip | 77406-1296
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Country | US
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Telephone | 979-250-1335
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | DR. TARA M JOHNSTON
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Credential | AU.D
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Telephone | 979-250-1335
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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 | 51343
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License Number State | TX
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