Provider Demographics
NPI:1811583719
Name:SEAUX-C BEAUTY LLC
Entity Type:Organization
Organization Name:SEAUX-C BEAUTY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONHEEM
Authorized Official - Middle Name:
Authorized Official - Last Name:BASS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-656-0157
Mailing Address - Street 1:15601 DALLAS PKWY STE 900
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-6098
Mailing Address - Country:US
Mailing Address - Phone:972-656-0157
Mailing Address - Fax:972-656-0158
Practice Address - Street 1:15601 DALLAS PKWY STE 900
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-6098
Practice Address - Country:US
Practice Address - Phone:972-656-0157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier