Healthcare Provider Details

I. General information

NPI: 1255082962
Provider Name (Legal Business Name): DAHAIR STUDIO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2022
Last Update Date: 01/13/2022
Certification Date: 01/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7111 FM 2920 RD STE 125
SPRING TX
77379-2208
US

IV. Provider business mailing address

7111 FM 2920 RD STE 125
SPRING TX
77379-2208
US

V. Phone/Fax

Practice location:
  • Phone: 936-206-8796
  • Fax: 832-442-6928
Mailing address:
  • Phone: 936-206-8796
  • Fax: 832-442-6928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: DOREEN L CLARK
Title or Position: CRANIAL PROSTHESIS SPECIALIST
Credential:
Phone: 936-206-8796