Provider Demographics
NPI:1063983591
Name:HART, ASHLEE (HIS)
Entity type:Individual
Prefix:
First Name:ASHLEE
Middle Name:
Last Name:HART
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 MARSHALL RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-1608
Mailing Address - Country:US
Mailing Address - Phone:210-621-7595
Mailing Address - Fax:
Practice Address - Street 1:2530 MARSHALL RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78259-1608
Practice Address - Country:US
Practice Address - Phone:210-810-4206
Practice Address - Fax:210-497-8449
Is Sole Proprietor?:No
Enumeration Date:2018-12-10
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80847237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80847OtherHEARING INSTRUMENT SPECIALIST LICENSE NUMBER