MEDICARE: HAIR CONFUSION,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		TX

General Provider Information

NPI Number	:	1477708444
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAIR CONFUSION,LLC

Provider Business Mailing Address
First Line	:	PO BOX 141113
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75214-1113
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6060 N CENTRAL EXPY
Second Line	:	#560
City	:	DALLAS
State	:	TX
Zip	:	75206-5209
Country	:	US
Telephone Number	:	972-200-3533
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	LIBERTY MADISON
Credential	:
Telephone Number	:	972-200-3533

Provider Enumeration Date	:	11/18/2008
Last Update Date	:	07/21/2022

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