MEDICARE: TEXTURES HAIRSALON HAIRRESTORATION CENTER 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	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1720941628
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXTURES HAIRSALON HAIRRESTORATION CENTER LLC

Provider Business Mailing Address
First Line	:	3709 N 20TH ST
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76708-2021
Country	:	US
Telephone Number	:	254-744-8242
Fax Number	:

Provider Business Practice Location Address
First Line	:	3709 N 20TH ST
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76708-2021
Country	:	US
Telephone Number	:	254-744-8242
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. NITOSHIA V MITCHELL
Credential	:	CRANIAL PROSTHESIS S
Telephone Number	:	254-744-8242

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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