Provider Demographics
NPI:1730533324
Name:ATHENS HEARING CENTER LLC
Entity type:Organization
Organization Name:ATHENS HEARING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TINA
Authorized Official - Middle Name:P
Authorized Official - Last Name:ELKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-675-2222
Mailing Address - Street 1:1701 S PALESTINE ST STE B
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TX
Mailing Address - Zip Code:75751-5740
Mailing Address - Country:US
Mailing Address - Phone:903-675-2222
Mailing Address - Fax:903-675-1838
Practice Address - Street 1:1701 S PALESTINE ST STE B
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751-5740
Practice Address - Country:US
Practice Address - Phone:903-675-2222
Practice Address - Fax:903-675-1838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0711237700000X
TX50434237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty