Provider Demographics
NPI:1215933627
Name:CAUDLE, CHRIS DAVID (AUD)
Entity type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:DAVID
Last Name:CAUDLE
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:DR
Other - First Name:CHRIS
Other - Middle Name:DAVID
Other - Last Name:CAUDLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AUD
Mailing Address - Street 1:2540 LILLIAN MILLER PKWY
Mailing Address - Street 2:STE 100
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-7214
Mailing Address - Country:US
Mailing Address - Phone:940-387-0550
Mailing Address - Fax:940-387-0663
Practice Address - Street 1:2540 LILLIAN MILLER PKWY
Practice Address - Street 2:STE 100
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-7214
Practice Address - Country:US
Practice Address - Phone:940-387-0550
Practice Address - Fax:940-387-0663
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50424231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX199829601Medicaid
TXR70330Medicare UPIN
TX199829601Medicaid