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NPI Code Detail

MEDICARE: BETSY ANN HATHERILL M.S., CCC-A

MEDICARE: BETSY ANN HATHERILL M.S., CCC-A
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
1231H00000XAudiologist50601TX
2231HA2500XAssistive Technology Supplier Audiologist50601TX
3237700000XHearing Instrument Specialist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083611891
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETSY ANN HATHERILL M.S., CCC-A
Provider Business Mailing Address
First Line : 6199 CENTRAL CITY BLVD
Second Line : SUITE 122
City : GALVESTON
State : TX
Zip : 77551-3818
Country : US
Telephone Number : 409-765-5500
Fax Number : 409-744-8508
Provider Business Practice Location Address
First Line : 26222 RANCH RD 12
Second Line :
City : DRIPPING SPRINGS
State : TX
Zip : 78620-4903
Country : US
Telephone Number : 512-858-0300
Fax Number : 512-858-2714
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 08/14/2008

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