Healthcare Provider Details

I. General information

NPI: 1699449470
Provider Name (Legal Business Name): INSPIRED BEAUTY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2021
Last Update Date: 08/04/2021
Certification Date: 08/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7606 BRISTON PARK DR
SAN ANTONIO TX
78249-4711
US

IV. Provider business mailing address

7606 BRISTON PARK DR
SAN ANTONIO TX
78249-4711
US

V. Phone/Fax

Practice location:
  • Phone: 210-995-0194
  • Fax:
Mailing address:
  • Phone: 210-995-0194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZA2600X
TaxonomyMedical Art Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: CRYSTAL E YANG
Title or Position: MEMBER
Credential:
Phone: 210-995-0194