Provider Demographics
NPI:1104566975
Name:OCEAN WAVE HEARING
Entity type:Organization
Organization Name:OCEAN WAVE HEARING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEARING INSTRUMENT SPECIALIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:CARLOS
Authorized Official - Last Name:CAVAZOS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:361-201-8102
Mailing Address - Street 1:6034 TIMBERGATE DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-3895
Mailing Address - Country:US
Mailing Address - Phone:361-201-8102
Mailing Address - Fax:361-264-1471
Practice Address - Street 1:6034 TIMBERGATE DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-3895
Practice Address - Country:US
Practice Address - Phone:361-201-8102
Practice Address - Fax:361-264-1471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty