Provider Demographics
NPI:1538872833
Name:HBCA TEXAS, LLC
Entity type:Organization
Organization Name:HBCA TEXAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GULLICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-253-0937
Mailing Address - Street 1:150 WILLOW CREEK DR STE 105
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76085-3652
Mailing Address - Country:US
Mailing Address - Phone:817-550-6115
Mailing Address - Fax:866-358-6404
Practice Address - Street 1:150 WILLOW CREEK DR STE 105
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76085-3652
Practice Address - Country:US
Practice Address - Phone:817-550-6115
Practice Address - Fax:866-358-6404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty