Provider Demographics
NPI:1669029849
Name:MONIKA J SALON LLC
Entity Type:Organization
Organization Name:MONIKA J SALON LLC
Other - Org Name:MONIKA J SALON AND HAIR REPLACEMENT CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:HAIR REPLACEMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MONIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-666-4525
Mailing Address - Street 1:1100 MEREDITH LN APT 1123
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4672
Mailing Address - Country:US
Mailing Address - Phone:773-331-5575
Mailing Address - Fax:
Practice Address - Street 1:17610 MIDWAY RD STE 122
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-6741
Practice Address - Country:US
Practice Address - Phone:833-666-4525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-21
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Multi-Specialty