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General NPI Number Information
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NPI Number | 1700215092
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Entity Type | Individual
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Provider Name | LOGAN PRICE
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Gender | Male
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Dates
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Enumeration Date | 11/06/2013
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Last Update Date | 01/24/2020
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Provider Practice Location Address
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Address Line | 2481 E 11TH ST
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City | ODESSA
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State | TX
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Zip | 79761-4232
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Country | US
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Telephone | 432-335-9514
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Fax | 432-335-0906
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Provider Business Mailing Address
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Address Line | 2481 E 11TH ST
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City | ODESSA
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State | TX
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Zip | 79761-4232
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Country | US
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Telephone | 432-335-9514
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Fax | 432-335-0906
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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 | 80511
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License Number State | TX
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