Provider Demographics
NPI:1346801271
Name:FASHION ACQUIRED PLANET 9 COMPANY
Entity Type:Organization
Organization Name:FASHION ACQUIRED PLANET 9 COMPANY
Other - Org Name:SHARETTA SUBLETT
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUBLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-664-8429
Mailing Address - Street 1:3604 CHATHAM GREEN LN APT 2034
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-3726
Mailing Address - Country:US
Mailing Address - Phone:682-270-8808
Mailing Address - Fax:
Practice Address - Street 1:3604 CHATHAM GREEN LN APT 2034
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-3726
Practice Address - Country:US
Practice Address - Phone:682-270-8808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-21
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246YC3301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationCoding Specialist, Hospital BasedGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8337100019Medicaid