MEDICARE: HIGHLAND PARK HEARING

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	332S00000X	Hearing Aid Equipment	32039382018	TX

General Provider Information

NPI Number	:	1669704375
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIGHLAND PARK HEARING

Provider Business Mailing Address
First Line	:	4310 HOLLAND AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75219-2842
Country	:	US
Telephone Number	:	254-968-2246
Fax Number	:	254-965-2802

Provider Business Practice Location Address
First Line	:	763 N GRAHAM ST
Second Line	:
City	:	STEPHENVILLE
State	:	TX
Zip	:	76401-3148
Country	:	US
Telephone Number	:	254-968-2246
Fax Number	:	254-965-2802

Authorized Official
Title or Position	:	OWNER
Name	:	EIMEAR MCGONAGLE
Credential	:
Telephone Number	:	254-968-2246

Provider Enumeration Date	:	02/04/2010
Last Update Date	:	02/04/2010

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Directions to “HIGHLAND PARK HEARING ” Practice Location

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