Provider Demographics
NPI:1376078881
Name:LITTLE BLACK BAG HOUSE CALLS LLC
Entity Type:Organization
Organization Name:LITTLE BLACK BAG HOUSE CALLS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUMMER
Authorized Official - Middle Name:
Authorized Official - Last Name:NAPIER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:940-613-1123
Mailing Address - Street 1:901 INDIANA AVE
Mailing Address - Street 2:SUITE 635
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-6719
Mailing Address - Country:US
Mailing Address - Phone:940-217-5589
Mailing Address - Fax:
Practice Address - Street 1:901 INDIANA AVE
Practice Address - Street 2:SUITE 635
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-6719
Practice Address - Country:US
Practice Address - Phone:940-217-5589
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-22
Last Update Date:2017-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty