Provider Demographics
NPI:1609107697
Name:RICKY KNOWLES HAIR AND WELLNESS
Entity Type:Organization
Organization Name:RICKY KNOWLES HAIR AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICKY
Authorized Official - Middle Name:NORMAN
Authorized Official - Last Name:KNOLWES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-484-9647
Mailing Address - Street 1:3106 MELODY PEAK LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-2553
Mailing Address - Country:US
Mailing Address - Phone:713-484-9647
Mailing Address - Fax:281-485-4262
Practice Address - Street 1:4615 SOUTHWEST FWY
Practice Address - Street 2:#420
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7108
Practice Address - Country:US
Practice Address - Phone:713-484-9647
Practice Address - Fax:281-485-4262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1130614332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies