Provider Demographics
NPI:1518618818
Name:SWEETEST BRAIDS BY SWEETPEA
Entity Type:Organization
Organization Name:SWEETEST BRAIDS BY SWEETPEA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LASHUNDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-685-7153
Mailing Address - Street 1:12353 KERRISON WAY APT 618
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-4174
Mailing Address - Country:US
Mailing Address - Phone:469-685-7153
Mailing Address - Fax:
Practice Address - Street 1:12353 KERRISON WAY APT 618
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-4174
Practice Address - Country:US
Practice Address - Phone:469-685-7153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment