Provider Demographics
NPI:1558502005
Name:7 SISTERS CARE HEALTH BOUTIQUE,INC.
Entity Type:Organization
Organization Name:7 SISTERS CARE HEALTH BOUTIQUE,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/MGR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:T
Authorized Official - Last Name:HESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-572-0058
Mailing Address - Street 1:2015 MULBERRY AVE
Mailing Address - Street 2:STE 320
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455-2362
Mailing Address - Country:US
Mailing Address - Phone:903-572-0058
Mailing Address - Fax:903-577-9665
Practice Address - Street 1:2015 MULBERRY AVE
Practice Address - Street 2:STE. 320
Practice Address - City:MOUNT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-2362
Practice Address - Country:US
Practice Address - Phone:903-572-0058
Practice Address - Fax:903-577-9665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-13
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32039073146335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6336080001Medicare NSC