MEDICARE: STOUT FAMILY HEARING, 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	332S00000X	Hearing Aid Equipment

General Provider Information

NPI Number	:	1952071383
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STOUT FAMILY HEARING, LLC

Provider Business Mailing Address
First Line	:	1505 BEVERLY DR
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76309-2124
Country	:	US
Telephone Number	:	940-723-4200
Fax Number	:	940-723-4203

Provider Business Practice Location Address
First Line	:	1505 BEVERLY DR
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76309-2124
Country	:	US
Telephone Number	:	940-723-4200
Fax Number	:	940-723-4203

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	STEVEN DANIEL STOUT
Credential	:
Telephone Number	:	940-723-4200

Provider Enumeration Date	:	09/16/2021
Last Update Date	:	09/21/2021

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