MEDICARE: DR. BLAIR T. WEBB AUD

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	231H00000X	Audiologist	80031	TX
2	231HA2400X	Assistive Technology Practitioner Audiologist
3	237600000X	Audiologist-Hearing Aid Fitter	80031	TX

General Provider Information

NPI Number	:	1891926887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BLAIR T. WEBB AUD

Provider Business Mailing Address
First Line	:	5931 MEADOWSIDE ST
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-4511
Country	:	US
Telephone Number	:	281-284-0355
Fax Number	:	281-284-9954

Provider Business Practice Location Address
First Line	:	5931 MEADOWSIDE ST
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-4511
Country	:	US
Telephone Number	:	281-284-0355
Fax Number	:	281-284-9954

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2009
Last Update Date	:	08/07/2009

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