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General NPI Number Information
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NPI Number | 1093248924
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Entity Type | Organization
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Legal Business Name | LUX AESTHETIC MEDICAL SERVICES, LLC
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Dates
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Enumeration Date | 04/07/2017
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Last Update Date | 04/07/2017
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Provider Practice Location Address
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Address Line | 530 S WACO ST
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City | VAN ALSTYNE
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State | TX
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Zip | 75495-7110
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Country | US
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Telephone | 844-589-7233
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Fax | 877-457-8231
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Provider Business Mailing Address
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Address Line | PO BOX 1169
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City | VAN ALSTYNE
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State | TX
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Zip | 75495-1169
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Country | US
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Telephone | 844-589-7233
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Fax | 877-457-8231
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. BARBARA GRIFFIN
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Credential | R.N.
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Telephone | 844-589-7233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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