Active NPI
Phillip Gandy
- Audiologist-Hearing Aid Fitter
- Mansfield, TX
National Provider Identifier
1114291150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist-Hearing Aid Fitter
- License
- 11106
- Practice address
- 1710 Country Club Dr
102
Mansfield, TX 76063-2623 - Phone
- (817) 779-6955
- Fax
- (817) 473-9963
- NPI assigned
- Mar 7, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist-Hearing Aid Fitter | 237600000X | 11106 | TX | Primary |
Addresses
Primary practice location
1710 Country Club Dr
102
Mansfield, TX 76063-2623
Mailing address
400 S Henderson St
Fort Worth, TX 76104-1017
Phone (817) 335-2583
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11106 | TX | MD | Audiologist-Hearing Aid Fitter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331078400000",
"number": "1114291150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 S HENDERSON ST",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761041017",
"telephone_number": "817-335-2583",
"fax_number": "817-546-3672"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1710 COUNTRY CLUB DR",
"address_2": "102",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760632623",
"telephone_number": "817-779-6955",
"fax_number": "817-473-9963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANDY",
"first_name": "PHILLIP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-03-07",
"last_updated": "2012-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "TX",
"license": "11106",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.