Provider Demographics
NPI:1134622343
Name:DOLL HOUSE MEDSPA LLC
Entity type:Organization
Organization Name:DOLL HOUSE MEDSPA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESE
Authorized Official - Middle Name:
Authorized Official - Last Name:RIZZO
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:210-843-3565
Mailing Address - Street 1:1205 N. LOOP 1064 W
Mailing Address - Street 2:SUITE 225
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258
Mailing Address - Country:US
Mailing Address - Phone:210-437-2759
Mailing Address - Fax:210-253-9302
Practice Address - Street 1:1205 N LOOP 1064 W
Practice Address - Street 2:SUITE 225
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258
Practice Address - Country:US
Practice Address - Phone:210-437-2759
Practice Address - Fax:210-253-9302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty