MEDICARE: ROYALTY'S EXCLUSIVE EXTENSIONS

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1548116098
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYALTY'S EXCLUSIVE EXTENSIONS

Provider Business Mailing Address
First Line	:	2001 E SPRING CREEK PKWY APT 4210
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75074-3236
Country	:	US
Telephone Number	:	205-835-3952
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 14TH ST
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75074-6459
Country	:	US
Telephone Number	:	205-835-3952
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JAMEKA R SMITH
Credential	:
Telephone Number	:	205-835-3952

Provider Enumeration Date	:	03/07/2026
Last Update Date	:	03/07/2026

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Directions to “ROYALTY'S EXCLUSIVE EXTENSIONS ” Practice Location

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