Provider Demographics
NPI:1003061474
Name:PLANO ALL ABOUT YOU SALON LLC
Entity type:Organization
Organization Name:PLANO ALL ABOUT YOU SALON LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-985-4477
Mailing Address - Street 1:3115 W PARKER RD
Mailing Address - Street 2:STE 345
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-8137
Mailing Address - Country:US
Mailing Address - Phone:972-985-4477
Mailing Address - Fax:972-596-3898
Practice Address - Street 1:3115 W PARKER RD
Practice Address - Street 2:STE 345
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-8137
Practice Address - Country:US
Practice Address - Phone:972-985-4477
Practice Address - Fax:972-596-3898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-26
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6307340001Medicare NSC