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General NPI Number Information
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NPI Number | 1578897252
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Entity Type | Organization
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Legal Business Name | FONNER HEARING AID CENTER
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Dates
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Enumeration Date | 09/28/2009
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Last Update Date | 09/28/2009
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Provider Practice Location Address
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Address Line | 315 E RANDOL MILL RD
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City | ARLINGTON
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State | TX
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Zip | 76011-5838
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Country | US
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Telephone | 817-277-8121
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Fax | 817-284-3253
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Provider Business Mailing Address
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Address Line | 315 E RANDOL MILL RD
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City | ARLINGTON
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State | TX
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Zip | 76011-5838
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Country | US
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Telephone | 817-277-8121
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Fax | 817-284-3253
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Authorized Official
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Title or Position | PROVIDER
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Name | MRS. JULIE FONNER
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Credential | BC, NBC-HIS, ACA,
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Telephone | 817-277-8121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | 50358
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License Number State | TX
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