Provider Demographics
NPI:1659098143
Name:MESHA MICHELLE BEAUTY BRANDS
Entity Type:Organization
Organization Name:MESHA MICHELLE BEAUTY BRANDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-878-3102
Mailing Address - Street 1:11900 RESEARCH RD APT 3414
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-3699
Mailing Address - Country:US
Mailing Address - Phone:972-878-3102
Mailing Address - Fax:
Practice Address - Street 1:11900 RESEARCH RD APT 3414
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-3699
Practice Address - Country:US
Practice Address - Phone:972-878-3102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MESHA MICHELLE BEAUTY BRANDS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier