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General NPI Number Information
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NPI Number | 1821992728
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Entity Type | Organization
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Legal Business Name | SUPREME BEAUTY 4 INC
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 800 E KNIGHTS WAY
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City | HARKER HEIGHTS
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State | TX
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Zip | 76548-5731
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Country | US
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Telephone | 951-662-7734
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Fax |
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Provider Business Mailing Address
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Address Line | 800 E KNIGHTS WAY
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City | HARKER HEIGHTS
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State | TX
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Zip | 76548-5731
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Country | US
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Telephone | 951-662-7734
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. SAMER ALI AHMAD
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Credential |
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Telephone | 951-662-7734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | NULL
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