Provider Demographics
NPI:1063778421
Name:ALLEN HEARING CLINIC, INC.
Entity type:Organization
Organization Name:ALLEN HEARING CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-747-1333
Mailing Address - Street 1:423 E MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-3345
Mailing Address - Country:US
Mailing Address - Phone:972-723-6181
Mailing Address - Fax:
Practice Address - Street 1:423 E MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-3345
Practice Address - Country:US
Practice Address - Phone:972-723-6181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech