Provider Demographics
NPI:1730664087
Name:SPOILED UNLIMITED LLC
Entity Type:Organization
Organization Name:SPOILED UNLIMITED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HAIR REPLACEMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIMFARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-957-0014
Mailing Address - Street 1:2507 LACEWING LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77067-3317
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5288 W 34TH ST STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-6624
Practice Address - Country:US
Practice Address - Phone:713-957-0014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Multi-Specialty