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General NPI Number Information
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NPI Number | 1578112819
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Entity Type | Organization
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Legal Business Name | STYLES BY ANGIE K, LLC
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Dates
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Enumeration Date | 09/10/2019
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Last Update Date | 09/10/2019
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Provider Practice Location Address
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Address Line | 5402 ARAPAHO RD
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City | DALLAS
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State | TX
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Zip | 75248-6905
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Country | US
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Telephone | 972-934-0047
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Fax |
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Provider Business Mailing Address
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Address Line | 6517 CHALK CT
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City | PLANO
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State | TX
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Zip | 75023-2904
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Country | US
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Telephone | 214-794-0305
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Fax |
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Authorized Official
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Title or Position | HAIR REPLACEMENT SPECIALIST
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Name | ANGELA KINARD
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Credential |
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Telephone | 972-934-0047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1744P3200X
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Taxonomy Name | Prosthetics Case Management
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License Number |
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License Number State |
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