MEDICARE: MEMORIAL HEARING, 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
1	261QH0700X	Hearing and Speech Clinic/Center	80074	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1396916706	OTHER	TX	NPI

General Provider Information

NPI Number	:	1851700702
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEMORIAL HEARING, PLLC

Provider Business Mailing Address
First Line	:	908 TOWN AND COUNTRY BLVD STE 120
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-2208
Country	:	US
Telephone Number	:	713-984-7562
Fax Number	:

Provider Business Practice Location Address
First Line	:	908 TOWN AND COUNTRY BLVD STE 120
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-2208
Country	:	US
Telephone Number	:	713-984-7562
Fax Number	:

Authorized Official
Title or Position	:	AUDIOLOGIST/OWNER
Name	:	ELLY POURASEF
Credential	:	AU.D.
Telephone Number	:	713-984-7562

Provider Enumeration Date	:	08/05/2014
Last Update Date	:	08/05/2014

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Directions to “MEMORIAL HEARING, PLLC ” Practice Location

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