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NPI Code Detail

MEDICARE: SALLY E MULHBACH AUD, PLLC

MEDICARE: SALLY E MULHBACH AUD, PLLC
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
1231H00000XAudiologist51152TX

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 : 1285875278
Entity Type Code : Organization
Provider Name (Legal Business Name) : SALLY E MULHBACH AUD, PLLC
Provider Business Mailing Address
First Line : 609 E LUFKIN AVE
Second Line :
City : LUFKIN
State : TX
Zip : 75901-4043
Country : US
Telephone Number : 936-632-2252
Fax Number : 936-632-0712
Provider Business Practice Location Address
First Line : 609 E LUFKIN AVE
Second Line :
City : LUFKIN
State : TX
Zip : 75901-4043
Country : US
Telephone Number : 936-632-2252
Fax Number : 936-632-0712
Authorized Official
Title or Position : AUDIOLOGIST
Name : SALLY ESTILL MUHLBACH
Credential : AUD
Telephone Number : 936-632-2252
Provider Enumeration Date : 03/20/2009
Last Update Date : 06/24/2009

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