Provider Demographics
NPI:1710498696
Name:TRIEXPERTS
Entity Type:Organization
Organization Name:TRIEXPERTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:DALLASCIET
Authorized Official - Middle Name:HARPER
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:HAIR LOSS SPECIALIST
Authorized Official - Phone:601-910-8325
Mailing Address - Street 1:606 MCDONALD DR APT E4
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39056-5303
Mailing Address - Country:US
Mailing Address - Phone:601-278-9175
Mailing Address - Fax:
Practice Address - Street 1:220 SAINT PAUL ST
Practice Address - Street 2:
Practice Address - City:PEARL
Practice Address - State:MS
Practice Address - Zip Code:39208-5134
Practice Address - Country:US
Practice Address - Phone:601-910-8325
Practice Address - Fax:601-806-3060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-18
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty