Kelly L Archer, AUD
Individual provider Active NPI Audiologist · Dallas, TX
NPI 1154769289 · NPPES record last updated Dec 15, 2022
Key facts
- NPI
- 1154769289
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist 231H00000X
- License
- 80502 (TX)
- Practice address
- 1966 Inwood Rd
Dallas, TX 75235-7205 - Phone
- (972) 883-3000
- Fax
- (972) 883-3068
- NPI assigned
- Jun 11, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 80502 | TX | MD | Hearing Instrument Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cook Children'S Physician Network | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 80502 | TX | Yes |
Addresses
Primary practice location
1966 Inwood Rd
Dallas, TX 75235-7205
Mailing address
2935 Salina Dr
Grand Prairie, TX 75054-0193
Phone (972) 251-0139
Other practice location 1
3132 Matlock Rd
Ste 303
Arlington, TX 76015-2910
Phone (817) 472-7720
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.