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General NPI Number Information
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NPI Number | 1467694653
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Entity Type | Individual
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Provider Name | VIRGIL ALLEN LEE H.I.S.
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Gender | Male
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Dates
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Enumeration Date | 04/02/2009
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Last Update Date | 04/02/2009
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Provider Practice Location Address
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Address Line | 9023 OXFORD CEMETERY RD
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City | MADISONVILLE
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State | TX
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Zip | 77864-6055
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Country | US
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Telephone | 979-324-7057
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Fax | 936-348-2298
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Provider Business Mailing Address
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Address Line | 9023 OXFORD CEMETERY RD
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City | MADISONVILLE
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State | TX
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Zip | 77864-6055
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Country | US
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Telephone | 979-324-7057
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Fax | 936-348-2298
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 80298
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License Number State | TX
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