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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