Provider Demographics
NPI:1104819291
Name:AMARILLO REGIONAL HEARING AND SPEECH FOUNDATION
Entity type:Organization
Organization Name:AMARILLO REGIONAL HEARING AND SPEECH FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SHERRON
Authorized Official - Middle Name:S
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, SLP
Authorized Official - Phone:806-359-7681
Mailing Address - Street 1:1300 WALLACE BLVD
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1745
Mailing Address - Country:US
Mailing Address - Phone:806-359-7681
Mailing Address - Fax:806-359-7755
Practice Address - Street 1:1300 WALLACE BLVD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1745
Practice Address - Country:US
Practice Address - Phone:806-359-7681
Practice Address - Fax:806-359-7755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX231H00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2493HMOtherBLUE CROSS BLUE SHIELD
TX2493HMOtherBLUE CROSS BLUE SHIELD
TX=========OtherFEDERAL TAX ID