Provider Demographics
NPI:1528615978
Name:FRIENDSHIP HEARING
Entity type:Organization
Organization Name:FRIENDSHIP HEARING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-994-7010
Mailing Address - Street 1:1520 E DENMAN AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75901-5817
Mailing Address - Country:US
Mailing Address - Phone:936-994-7010
Mailing Address - Fax:
Practice Address - Street 1:1520 E DENMAN AVE STE 102
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75901-5817
Practice Address - Country:US
Practice Address - Phone:936-994-7010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty