Provider Demographics
NPI:1528252459
Name:NORRIS, BENJAMIN WALTER (HEARING AID DISPENSE)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:WALTER
Last Name:NORRIS
Suffix:
Gender:M
Credentials:HEARING AID DISPENSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 E CENTRAL TEXAS EXPY
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76541-9125
Mailing Address - Country:US
Mailing Address - Phone:254-519-4327
Mailing Address - Fax:
Practice Address - Street 1:1111 E CENTRAL TEXAS EXPY
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-9125
Practice Address - Country:US
Practice Address - Phone:254-519-4327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50235237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist