Provider Demographics
NPI:1336883719
Name:SI'LOAM CO LLC
Entity Type:Organization
Organization Name:SI'LOAM CO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:TRINITY
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-234-3099
Mailing Address - Street 1:3139 W HOLCOMBE BLVD STE 2082
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-1533
Mailing Address - Country:US
Mailing Address - Phone:346-234-3099
Mailing Address - Fax:832-201-0838
Practice Address - Street 1:5110 GRIGGS RD APT 1241
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021-3233
Practice Address - Country:US
Practice Address - Phone:346-234-3099
Practice Address - Fax:832-201-0838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier