=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396678397
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CRANIAL CONFIDENCE SOLUTIONS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/08/2026
-----------------------------------------------------
Last Update Date | 06/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2626 COLE AVE STE 300
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75204-1094
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-954-4233
-----------------------------------------------------
Fax | 214-845-5530
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2626 COLE AVE STE 300
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75204-1094
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-954-4233
-----------------------------------------------------
Fax | 214-845-5530
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICER
-----------------------------------------------------
Name | SHAM PHILLIPS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 972-809-8987
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------