Provider Demographics
NPI:1871184317
Name:THE IVORY HAIR COMPANY
Entity Type:Organization
Organization Name:THE IVORY HAIR COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:ITAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-732-1445
Mailing Address - Street 1:PO BOX 41678
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77241-1678
Mailing Address - Country:US
Mailing Address - Phone:832-732-1445
Mailing Address - Fax:
Practice Address - Street 1:10350 S POST OAK RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-3313
Practice Address - Country:US
Practice Address - Phone:713-283-9300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment