=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700860483
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALAN MAC ROSS AUD/CCC-A
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/06/2005
-----------------------------------------------------
Last Update Date | 10/18/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | PSC 561 BOX 2182
-----------------------------------------------------
City | FPO
-----------------------------------------------------
State | AP
-----------------------------------------------------
Zip | 96310-0022
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 254-759-9823
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PSC 561 BOX 2182
-----------------------------------------------------
City | FPO
-----------------------------------------------------
State | AP
-----------------------------------------------------
Zip | 96310-0022
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 254-759-9823
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 231H00000X
-----------------------------------------------------
Taxonomy Name | Audiologist
-----------------------------------------------------
License Number | 51167
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------