Individual
JACKSON W RAINWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BBA
Contact information
Practice address
406 S NEBRASKA AVE, WESLACO, TX 78596-6024
(956) 968-6131
(956) 968-1807
Mailing address
406 S NEBRASKA AVE, WESLACO, TX 78596-6024
(956) 968-6131
(956) 968-1807
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
50195
TX
237700000X
Hearing Instrument Specialist
50195
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1127755-01
—
TX
05
—
1127755-02
—
TX
05
—
1127755-03
—
TX
05
—
3599474-02
—
TX
01
—
516433
BCBS PROVIDER NUMBER
TX
Enumeration date
07/07/2006
Last updated
01/02/2024
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