Provider Demographics
NPI:1447269402
Name:AUDIO ACOUSTICS HEARING CENTER OF LUBBOCK, INC
Entity type:Organization
Organization Name:AUDIO ACOUSTICS HEARING CENTER OF LUBBOCK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF AUDIOLOGY CLINICAL DIR
Authorized Official - Prefix:DR
Authorized Official - First Name:TONI
Authorized Official - Middle Name:DAVIS
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD CCCA
Authorized Official - Phone:806-798-3600
Mailing Address - Street 1:4505 82ND STREET
Mailing Address - Street 2:SUITE 8
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-3219
Mailing Address - Country:US
Mailing Address - Phone:806-798-3600
Mailing Address - Fax:806-798-3601
Practice Address - Street 1:4505 82ND STREET
Practice Address - Street 2:SUITE 8
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-3219
Practice Address - Country:US
Practice Address - Phone:806-798-3600
Practice Address - Fax:806-798-3601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX022447901Medicaid
007205OtherBLUE CROSS BLUE SHIELD
TX102313100OtherFIRST CARE LIFE HEALTH
TX531411OtherBCBS
TX00632EMedicare ID - Type Unspecified