MEDICARE: MR. JARROD M FREELAND H.I.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237600000X	Audiologist-Hearing Aid Fitter
2	237700000X	Hearing Instrument Specialist	80360	TX

General Provider Information

NPI Number	:	1063718609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JARROD M FREELAND H.I.S.

Provider Business Mailing Address
First Line	:	6700 WASHINGTON AVE S
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-3405
Country	:	US
Telephone Number	:	612-351-1529
Fax Number	:

Provider Business Practice Location Address
First Line	:	21820 KINGSLAND BLVD STE 104
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77450-2507
Country	:	US
Telephone Number	:	281-579-4374
Fax Number	:	281-579-7843

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2011
Last Update Date	:	02/20/2019

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