Provider Demographics
NPI:1659036275
Name:DOLLFACE TYCOONS LLC
Entity Type:Organization
Organization Name:DOLLFACE TYCOONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN-THOMPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-903-9165
Mailing Address - Street 1:15922 ELDORADO PKWY STE 500
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-5880
Mailing Address - Country:US
Mailing Address - Phone:214-210-7454
Mailing Address - Fax:
Practice Address - Street 1:3411 PRESTON RD STE 5
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-9011
Practice Address - Country:US
Practice Address - Phone:214-903-9165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Multi-Specialty