Provider Demographics
NPI:1750054987
Name:BEAUTIFUL CROWNS LLC
Entity Type:Organization
Organization Name:BEAUTIFUL CROWNS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIA
Authorized Official - Middle Name:CHARLENE
Authorized Official - Last Name:LINDSEY
Authorized Official - Suffix:
Authorized Official - Credentials:PROSTHETIC ORTHOTIC
Authorized Official - Phone:310-941-2636
Mailing Address - Street 1:1321 UPLAND DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-4718
Mailing Address - Country:US
Mailing Address - Phone:310-941-2636
Mailing Address - Fax:877-278-7224
Practice Address - Street 1:13428 BEHRENS AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-3500
Practice Address - Country:US
Practice Address - Phone:310-941-2636
Practice Address - Fax:877-278-7224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-24
Last Update Date:2021-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier