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General NPI Number Information
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NPI Number | 1518792670
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Entity Type | Organization
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Legal Business Name | BRAZILIAN BEAUTY MEDSPA LLC
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Dates
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Enumeration Date | 09/06/2024
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 4645 WYNDHAM LN STE 220B
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City | FRISCO
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State | TX
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Zip | 75033-0004
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Country | US
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Telephone | 833-601-8086
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Fax |
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Provider Business Mailing Address
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Address Line | 11625 CUSTER RD STE 110-237
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City | FRISCO
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State | TX
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Zip | 75035-8783
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | GUILHERME OLIVEIRA
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Credential |
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Telephone | 469-345-1035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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