Provider Demographics
NPI:1740950864
Name:POSH REMY HAIR LLC
Entity type:Organization
Organization Name:POSH REMY HAIR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CALVIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:PROCTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-603-4551
Mailing Address - Street 1:300 TRAILHOUSE LN APT 611
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-2650
Mailing Address - Country:US
Mailing Address - Phone:214-603-4551
Mailing Address - Fax:
Practice Address - Street 1:2063 TOWN EAST MALL
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-4118
Practice Address - Country:US
Practice Address - Phone:214-603-4551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service