Provider Demographics
NPI:1013394055
Name:BABIES 411 LLC
Entity Type:Organization
Organization Name:BABIES 411 LLC
Other - Org Name:MY PURE DELIVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIBA
Authorized Official - Middle Name:AZIN
Authorized Official - Last Name:TILLERY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, IBCLC
Authorized Official - Phone:512-765-9959
Mailing Address - Street 1:9311 N FM 620 RD
Mailing Address - Street 2:# 247
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78726-4129
Mailing Address - Country:US
Mailing Address - Phone:512-765-9959
Mailing Address - Fax:888-227-7057
Practice Address - Street 1:301 BRUSHY CREEK RD
Practice Address - Street 2:STE 106
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-3151
Practice Address - Country:US
Practice Address - Phone:512-765-9959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-29
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Multi-Specialty