Provider Demographics
NPI:1912116740
Name:AUSTIN HEARING AID CENTER
Entity type:Organization
Organization Name:AUSTIN HEARING AID CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:RUDOLPH
Authorized Official - Suffix:JR
Authorized Official - Credentials:MA, CCC-A
Authorized Official - Phone:512-444-8684
Mailing Address - Street 1:4403 MANCHACA RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1680
Mailing Address - Country:US
Mailing Address - Phone:512-444-8684
Mailing Address - Fax:512-444-8697
Practice Address - Street 1:4403 MANCHACA RD
Practice Address - Street 2:SUITE E
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1680
Practice Address - Country:US
Practice Address - Phone:512-444-8684
Practice Address - Fax:512-444-8697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50378261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1730249160OtherINDIVIDUAL NPI NUMBER
TX514099OtherBCBS