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General NPI Number Information
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NPI Number | 1750965828
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Entity Type | Organization
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Legal Business Name | EXCLUSIVE TRESSES, LLC
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Dates
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Enumeration Date | 05/05/2021
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Last Update Date | 05/05/2021
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Provider Practice Location Address
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Address Line | 363 N SAM HOUSTON PKWY E STE 11001526
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City | HOUSTON
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State | TX
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Zip | 77060-2404
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Country | US
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Telephone | 404-838-8133
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Fax |
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Provider Business Mailing Address
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Address Line | 363 N SAM HOUSTON PKWY E STE 11001526
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City | HOUSTON
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State | TX
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Zip | 77060-2404
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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 | MANAGER
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Name | ERICA BROWN
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Credential |
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Telephone | 678-663-3252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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