Provider Demographics
NPI:1598461147
Name:HAIR AND SKIN SCIENCE CENTER
Entity Type:Organization
Organization Name:HAIR AND SKIN SCIENCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KUDAKWASHE
Authorized Official - Middle Name:
Authorized Official - Last Name:MALONEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-758-9472
Mailing Address - Street 1:1127 ELDRIDGE PKWY STE 300-110
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-1771
Mailing Address - Country:US
Mailing Address - Phone:281-979-4238
Mailing Address - Fax:
Practice Address - Street 1:13714 ASHLEY RUN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-1511
Practice Address - Country:US
Practice Address - Phone:617-758-9472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CNK TELEHEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-06
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service