MEDICARE: BEAUTIFULLY MADE HAIR AND FACES 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1881544922
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEAUTIFULLY MADE HAIR AND FACES LLC

Provider Business Mailing Address
First Line	:	5783 TOSCANA TRCE
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-4406
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5783 TOSCANA TRCE
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-4406
Country	:	US
Telephone Number	:	512-944-8883
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KATESHIA L MACK
Credential	:
Telephone Number	:	512-944-8883

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	01/29/2026

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