MEDICARE: LOREN'S HAIR STUDIO

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	1744P3200X	Prosthetics Case Management

General Provider Information

NPI Number	:	1851767321
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOREN'S HAIR STUDIO

Provider Business Mailing Address
First Line	:	11003 WICKLOWE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77016-1871
Country	:	US
Telephone Number	:	713-823-9952
Fax Number	:

Provider Business Practice Location Address
First Line	:	10950 NORTH FWY
Second Line	:	SUITE 214
City	:	HOUSTON
State	:	TX
Zip	:	77037-1108
Country	:	US
Telephone Number	:	713-823-9952
Fax Number	:

Authorized Official
Title or Position	:	OWNER/HAIR STYLIST
Name	:	LOREN DE'ANN HAYNES
Credential	:
Telephone Number	:	713-823-9952

Provider Enumeration Date	:	08/19/2015
Last Update Date	:	08/19/2015

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Directions to “LOREN'S HAIR STUDIO ” Practice Location

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