| Doctor Name: | KENNETH HAESLY |
| NPI Number: | 1255787438 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 4111 Fairmont Pkwy Ste 103a Pasadena, TX - 775043326 |
| Business Phone Number: | 7134720000 |
| Business Fax Number: | |
| Mailing Address: | 4111 Fairmont Pkwy Ste 103a, PASADENA |
| State: | TX |
| Postal Code: | 775043326 |
| Phone Number: | 7134720000 |
| Fax Number: | |
| NPI Enumeration Date: | 05/06/2016 |
| NPI Last Update Date: | 05/06/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332S00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Hearing Aid Equipment |
| Taxonomy Specialization: | |
| Taxonomy Definition: | The manufacture and/or sale of electronic hearing aids, their component parts, and related products and services on a national basis. |