MEDICARE: LINDAS SIGNATURE HAIR STUDIO INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier
2	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1184230815
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDAS SIGNATURE HAIR STUDIO INC

Provider Business Mailing Address
First Line	:	9803 MASTERS RD
Second Line	:
City	:	MANVEL
State	:	TX
Zip	:	77578-4973
Country	:	US
Telephone Number	:	832-418-2998
Fax Number	:

Provider Business Practice Location Address
First Line	:	9415 BROADWAY ST STE 201
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-8094
Country	:	US
Telephone Number	:	832-418-2999
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LINDA BOYCE
Credential	:
Telephone Number	:	832-418-2999

Provider Enumeration Date	:	09/18/2020
Last Update Date	:	09/06/2021

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