Provider Demographics
NPI:1003667379
Name:THE SCALP BOSS LLC
Entity Type:Organization
Organization Name:THE SCALP BOSS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANEKA
Authorized Official - Middle Name:M
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:281-819-3467
Mailing Address - Street 1:11777 KATY FWY
Mailing Address - Street 2:SUITE 435N
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079
Mailing Address - Country:US
Mailing Address - Phone:281-819-3467
Mailing Address - Fax:281-885-2623
Practice Address - Street 1:11777 KATY FWY
Practice Address - Street 2:SUITE 435N
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079
Practice Address - Country:US
Practice Address - Phone:281-819-3467
Practice Address - Fax:281-885-2623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Multi-Specialty
No111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty