MEDICARE: MRS. GINGER LEA PEUGH AU.D.

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	80113	TX

General Provider Information

NPI Number	:	1164686168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GINGER LEA PEUGH AU.D.

Provider Business Mailing Address
First Line	:	2101 N MIDLAND DR STE 4
Second Line	:
City	:	MIDLAND
State	:	TX
Zip	:	79707-5593
Country	:	US
Telephone Number	:	432-689-4327
Fax Number	:	432-689-4329

Provider Business Practice Location Address
First Line	:	2101 N MIDLAND DR STE 4
Second Line	:
City	:	MIDLAND
State	:	TX
Zip	:	79707-5593
Country	:	US
Telephone Number	:	432-689-4327
Fax Number	:	432-689-4329

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

Provider Enumeration Date	:	07/18/2008
Last Update Date	:	07/18/2008

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