Provider Demographics
NPI:1033849682
Name:SEAN DAPPER STUDIO LLC
Entity Type:Organization
Organization Name:SEAN DAPPER STUDIO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COSMETOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SERENA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYSHACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-382-8410
Mailing Address - Street 1:17350 STATE HIGHWAY 249 STE 220
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-1132
Mailing Address - Country:US
Mailing Address - Phone:832-382-8410
Mailing Address - Fax:
Practice Address - Street 1:1818 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-6489
Practice Address - Country:US
Practice Address - Phone:832-382-8410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier