Provider Demographics
NPI:1417601915
Name:ANGELINA MICHELLE'S SIGNATURE HAIR COMPANY LLC
Entity Type:Organization
Organization Name:ANGELINA MICHELLE'S SIGNATURE HAIR COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELINA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:LETMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-459-1037
Mailing Address - Street 1:2525 W PLEASANT RUN RD APT 7J
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-1148
Mailing Address - Country:US
Mailing Address - Phone:682-459-1037
Mailing Address - Fax:
Practice Address - Street 1:1666 N HAMPTON RD STE 112
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2390
Practice Address - Country:US
Practice Address - Phone:214-915-8586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier