Organization
TYLER RDSPD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHY ROBERTSON (COORDINATOR RDSPD)
(903) 262-1032
Entity
Organization
Contact information
Practice address
807 W GLENWOOD BLVD, TYLER, TX 75701-3929
(903) 262-1032
(903) 262-1165
Mailing address
807 W GLENWOOD BLVD, TYLER, TX 75701-3929
(903) 262-1032
(903) 262-1165
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
50557
TX
231HA2400X
Assistive Technology Practitioner Audiologist
50557
TX
231HA2500X
Assistive Technology Supplier Audiologist
50557
TX
237600000X
Audiologist-Hearing Aid Fitter
Primary
50557
TX
237700000X
Hearing Instrument Specialist
50557
TX
Other
Enumeration date
09/16/2009
Last updated
09/16/2009
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