MEDICARE: RUBY'S WIG SALON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1356388748
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUBY'S WIG SALON

Provider Business Mailing Address
First Line	:	1515 BINGLE RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77055-3226
Country	:	US
Telephone Number	:	713-464-3767
Fax Number	:

Provider Business Practice Location Address
First Line	:	1515 BINGLE RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77055-3226
Country	:	US
Telephone Number	:	713-464-3767
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. JUDY BRYAN HARPER
Credential	:
Telephone Number	:	713-464-3767

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	08/18/2008

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Directions to “RUBY'S WIG SALON ” Practice Location

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