MEDICARE: MPJ AUDIOLOGY CONSULTANTS, LLC

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	51060	TX

General Provider Information

NPI Number	:	1427284785
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MPJ AUDIOLOGY CONSULTANTS, LLC

Provider Business Mailing Address
First Line	:	2450 LOUISIANA ST
Second Line	:	STE 400 524
City	:	HOUSTON
State	:	TX
Zip	:	77006-2380
Country	:	US
Telephone Number	:	713-491-4387
Fax Number	:	713-658-0827

Provider Business Practice Location Address
First Line	:	1315 ST JOSEPH PKWY
Second Line	:	STE 1604
City	:	HOUSTON
State	:	TX
Zip	:	77002-8233
Country	:	US
Telephone Number	:	713-491-4387
Fax Number	:	713-658-0827

Authorized Official
Title or Position	:	OWNER
Name	:	MONIQUE JENKINS
Credential	:	AUD
Telephone Number	:	713-491-4387

Provider Enumeration Date	:	06/01/2009
Last Update Date	:	07/28/2009

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