Provider Demographics
NPI:1306342621
Name:PROFESSIONAL HEARING HEALTHCARE PC
Entity type:Organization
Organization Name:PROFESSIONAL HEARING HEALTHCARE PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NAKIEA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:STRECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-209-5114
Mailing Address - Street 1:5022 E 101ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-5803
Mailing Address - Country:US
Mailing Address - Phone:918-518-5391
Mailing Address - Fax:918-209-5445
Practice Address - Street 1:5022 E 101ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-5803
Practice Address - Country:US
Practice Address - Phone:918-518-5391
Practice Address - Fax:918-209-5445
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROFESSIONAL HEARING HEALTHCARE PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty