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General NPI Number Information
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NPI Number | 1831897974
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Entity Type | Organization
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Legal Business Name | AUDIOLOGY CENTER OF NORTH TEXAS, LLC
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Dates
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Enumeration Date | 02/17/2023
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Last Update Date | 03/23/2023
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Provider Practice Location Address
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Address Line | 211 E SOUTHLAKE BLVD STE 114
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6274
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Country | US
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Telephone | 817-585-4080
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Fax |
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Provider Business Mailing Address
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Address Line | 211 E SOUTHLAKE BLVD STE 114
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6274
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Country | US
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Telephone | 817-585-4080
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | BROOKE CASEY
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Credential | AU.D.
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Telephone | 817-585-4080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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