Provider Demographics
NPI:1891188280
Name:ETRE BELLE MEDSPA LLC
Entity Type:Organization
Organization Name:ETRE BELLE MEDSPA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:LAPEYROUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-257-5560
Mailing Address - Street 1:22444 STATE HIGHWAY 249
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-1529
Mailing Address - Country:US
Mailing Address - Phone:281-257-5560
Mailing Address - Fax:866-611-3513
Practice Address - Street 1:22444 STATE HIGHWAY 249
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-1529
Practice Address - Country:US
Practice Address - Phone:281-257-5560
Practice Address - Fax:866-611-3513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-10
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service