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General NPI Number Information
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NPI Number | 1881539310
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Entity Type | Organization
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Legal Business Name | CROWNED WITH GLORY LLC
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Dates
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Enumeration Date | 04/21/2026
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Last Update Date | 04/21/2026
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Provider Practice Location Address
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Address Line | 7263 RUEDA
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City | GRAND PRAIRIE
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State | TX
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Zip | 75054-5526
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Country | US
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Telephone | 817-312-5121
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Fax |
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Provider Business Mailing Address
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Address Line | 7263 RUEDA
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City | GRAND PRAIRIE
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State | TX
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Zip | 75054-5526
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Country | US
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Telephone | 817-312-5121
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Fax |
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Authorized Official
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Title or Position | CRANIAL PROSTHESIS SPECIALIST
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Name | EUGENIA RENEE FERRELL
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Credential |
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Telephone | 817-312-5121
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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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