MEDICARE: DAHAIR STUDIO LLC

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

General Provider Information

NPI Number	:	1255082962
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAHAIR STUDIO LLC

Provider Business Mailing Address
First Line	:	7111 FM 2920 RD STE 125
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-2208
Country	:	US
Telephone Number	:	936-206-8796
Fax Number	:	832-442-6928

Provider Business Practice Location Address
First Line	:	7111 FM 2920 RD STE 125
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-2208
Country	:	US
Telephone Number	:	936-206-8796
Fax Number	:	832-442-6928

Authorized Official
Title or Position	:	CRANIAL PROSTHESIS SPECIALIST
Name	:	DOREEN L CLARK
Credential	:
Telephone Number	:	936-206-8796

Provider Enumeration Date	:	01/13/2022
Last Update Date	:	01/13/2022

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Directions to “DAHAIR STUDIO LLC ” Practice Location

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