MEDICARE: THE HAIR DIARY, LLC

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	174400000X	Specialist

General Provider Information

NPI Number	:	1932055605
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE HAIR DIARY, LLC

Provider Business Mailing Address
First Line	:	3120 SOUTHWEST FWY STE 101
Second Line	:	PMB 785007
City	:	HOUSTON
State	:	TX
Zip	:	77098-4520
Country	:	US
Telephone Number	:	281-520-7886
Fax Number	:

Provider Business Practice Location Address
First Line	:	2915 S SAM HOUSTON PKWY E STE 200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77047-6510
Country	:	US
Telephone Number	:	281-520-7886
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. JASMINE NICOLE ROGERS
Credential	:
Telephone Number	:	281-520-7886

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/05/2026

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Directions to “THE HAIR DIARY, LLC ” Practice Location

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