Provider Demographics
NPI:1255082962
Name:DAHAIR STUDIO LLC
Entity type:Organization
Organization Name:DAHAIR STUDIO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRANIAL PROSTHESIS SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-206-8796
Mailing Address - Street 1:7111 FM 2920 RD STE 125
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-2208
Mailing Address - Country:US
Mailing Address - Phone:936-206-8796
Mailing Address - Fax:832-442-6928
Practice Address - Street 1:7111 FM 2920 RD STE 125
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-2208
Practice Address - Country:US
Practice Address - Phone:936-206-8796
Practice Address - Fax:832-442-6928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier