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Organization
STEPHEN F. AUSTIN STATE UNIVERSITY COLE AUDIOLOGY LAB
Active
Organization
STEPHEN F. AUSTIN STATE UNIVERSITY COLE AUDIOLOGY LAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BAKER PATTILLO PH.D. (PRESIDENT)
(936) 468-2201
Entity
Organization
Contact information
Practice address
2100 N RAGUET, NO. 205, NACOGDOCHES, TX 75961
(936) 468-1252
(936) 468-7096
Mailing address
1936 N STREET AUSTIN 315, PO BOX 6145, SFA STATION, NACOGDOCHES, TX 75962-0001
(936) 468-2201
(936) 468-2202
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
80104
TX
Other
Enumeration date
07/02/2008
Last updated
07/02/2008
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