Provider Demographics
NPI:1336270131
Name:ABILENE SPEECH & HEARING CENTER
Entity type:Organization
Organization Name:ABILENE SPEECH & HEARING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:ASHBY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD (CCC-SLP&A)
Authorized Official - Phone:325-698-9048
Mailing Address - Street 1:6300 REGIONAL PLZ
Mailing Address - Street 2:SUITE 850
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-5251
Mailing Address - Country:US
Mailing Address - Phone:325-698-9048
Mailing Address - Fax:325-698-9060
Practice Address - Street 1:6300 REGIONAL PLZ
Practice Address - Street 2:SUITE 850
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5251
Practice Address - Country:US
Practice Address - Phone:325-698-9048
Practice Address - Fax:325-698-9060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50365231H00000X
TX11764235Z00000X
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
TX80140AOtherBCBS INSURANCE
TX514062Medicare ID - Type Unspecified