Provider Demographics
NPI:1801660287
Name:HIGH HEELS NETWORK LLC
Entity type:Organization
Organization Name:HIGH HEELS NETWORK LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAURETTA
Authorized Official - Middle Name:J
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-531-7234
Mailing Address - Street 1:2611 BAXTER DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-7081
Mailing Address - Country:US
Mailing Address - Phone:469-531-7234
Mailing Address - Fax:
Practice Address - Street 1:2909 E ARKANSAS LN STE C123
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-6941
Practice Address - Country:US
Practice Address - Phone:888-823-1820
Practice Address - Fax:682-281-2223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-07
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier