Provider Demographics
NPI:1154596658
Name:AUDIOLOGY AND HEARING SERVICES OF KERRVILLE PLLC
Entity type:Organization
Organization Name:AUDIOLOGY AND HEARING SERVICES OF KERRVILLE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:G
Authorized Official - Last Name:SIRIANNI
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:830-792-4060
Mailing Address - Street 1:703 HILL COUNTRY DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-6159
Mailing Address - Country:US
Mailing Address - Phone:830-792-4060
Mailing Address - Fax:830-792-5288
Practice Address - Street 1:703 HILL COUNTRY DR
Practice Address - Street 2:SUITE 102
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-6159
Practice Address - Country:US
Practice Address - Phone:830-792-4060
Practice Address - Fax:830-792-5288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149728101Medicaid
TX149728102Medicaid
TX528425OtherBCBS
TX580067Medicare PIN
TX149728101Medicaid
TX580067Medicare PIN