Provider Demographics
NPI:1043913551
Name:PRICELESS BEAUTY SPA,LLC
Entity Type:Organization
Organization Name:PRICELESS BEAUTY SPA,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:972-358-8109
Mailing Address - Street 1:1021 JUNE BUG LN
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-0008
Mailing Address - Country:US
Mailing Address - Phone:972-358-8109
Mailing Address - Fax:872-888-0554
Practice Address - Street 1:1021 JUNE BUG LN
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-0008
Practice Address - Country:US
Practice Address - Phone:972-358-8109
Practice Address - Fax:872-888-0554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-23
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care