MEDICARE: ALTEREGO HAIR SOLUTIONS, 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
2	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1629928205
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALTEREGO HAIR SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	1819 ATHENA DR
Second Line	:
City	:	LANCASTER
State	:	TX
Zip	:	75134-4171
Country	:	US
Telephone Number	:	855-346-4247
Fax Number	:

Provider Business Practice Location Address
First Line	:	1819 ATHENA DR
Second Line	:
City	:	LANCASTER
State	:	TX
Zip	:	75134-4171
Country	:	US
Telephone Number	:	855-346-4247
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	EBONY WALKER
Credential	:
Telephone Number	:	855-346-4247

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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