Individual
DR. MICA JILL INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
400 W IH 635 FWY STE 360, IRVING, TX 75063-3764
(972) 402-8404
(972) 695-8796
Mailing address
400 W IH 635 FWY STE 360, IRVING, TX 75063-3764
(972) 402-8404
(972) 695-8796
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
147001032
IL
231H00000X
Audiologist
Primary
51740
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
211151001
—
LA
Enumeration date
09/20/2007
Last updated
07/09/2018
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