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General NPI Number Information
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NPI Number | 1639975527
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Entity Type | Organization
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Legal Business Name | TDBI HAIR REPLACEMENT SOLUTIONS
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Dates
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Enumeration Date | 02/20/2025
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 8174 LAS VEGAS BLVD S STE 101
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City | LAS VEGAS
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State | NV
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Zip | 89123-1030
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Country | US
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Telephone | 702-720-3812
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Fax |
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Provider Business Mailing Address
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Address Line | 4200 HARRIS AVE
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City | LAS VEGAS
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State | NV
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Zip | 89110-2224
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Country | US
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Telephone | 702-720-3812
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Fax |
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Authorized Official
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Title or Position | CRANIAL PROSTHETICS SPECIALIST
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Name | THOMAS SIMMS
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Credential |
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Telephone | 702-720-3812
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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