Provider Demographics
NPI:1174237192
Name:LUCID HEARING HOLDING COMPANY LLC
Entity type:Organization
Organization Name:LUCID HEARING HOLDING COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ACCOUNTING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-554-9757
Mailing Address - Street 1:14301 FAA BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76155-2520
Mailing Address - Country:US
Mailing Address - Phone:817-554-9757
Mailing Address - Fax:
Practice Address - Street 1:14301 FAA BLVD STE 105
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76155-2520
Practice Address - Country:US
Practice Address - Phone:817-554-9757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech