MEDICARE: JOE D CRNKOVIC DBA AUDIBLE HEARING CENTER

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	332B00000X	Durable Medical Equipment & Medical Supplies
2	332S00000X	Hearing Aid Equipment
3	237700000X	Hearing Instrument Specialist	50263	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	516533	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1427122704
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOE D CRNKOVIC DBA AUDIBLE HEARING CENTER

Provider Business Mailing Address
First Line	:	2305 CAVITT AVE
Second Line	:
City	:	BRYAN
State	:	TX
Zip	:	77801
Country	:	US
Telephone Number	:	979-779-3070
Fax Number	:	979-779-7565

Provider Business Practice Location Address
First Line	:	2305 CAVITT AVE
Second Line	:
City	:	BRYAN
State	:	TX
Zip	:	77801-2006
Country	:	US
Telephone Number	:	979-779-3070
Fax Number	:	979-779-7565

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JOE D CRNKOVIC
Credential	:	ACA
Telephone Number	:	979-779-3070

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	06/20/2008

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Directions to “JOE D CRNKOVIC DBA AUDIBLE HEARING CENTER ” Practice Location

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