=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508634536
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | METX, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/19/2023
-----------------------------------------------------
Last Update Date | 12/19/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 919 E INTERSTATE 30 STE 127
-----------------------------------------------------
City | ROCKWALL
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75087-4885
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-897-4025
-----------------------------------------------------
Fax | 321-290-1298
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8300 CENTRAL PARK DR STE 100
-----------------------------------------------------
City | WACO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76712-6666
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 254-227-6825
-----------------------------------------------------
Fax | 254-300-4990
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VP OF MARKETING
-----------------------------------------------------
Name | NIDIA GARCIA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 254-227-6825
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 237700000X
-----------------------------------------------------
Taxonomy Name | Hearing Instrument Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------