Provider Demographics
NPI:1447338223
Name:ESTES AUDIOLOGY
Entity type:Organization
Organization Name:ESTES AUDIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SORIYA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ESTES
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:830-643-0033
Mailing Address - Street 1:1528 COMMON STREET
Mailing Address - Street 2:SUITE 5
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130
Mailing Address - Country:US
Mailing Address - Phone:830-643-0033
Mailing Address - Fax:830-643-0350
Practice Address - Street 1:1528 COMMON STREET
Practice Address - Street 2:SUITE 5
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130
Practice Address - Country:US
Practice Address - Phone:830-643-0033
Practice Address - Fax:830-643-0350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51386231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176599201Medicaid