Provider Demographics
NPI:1811526700
Name:VANN, ALICE (CERTIFIED HAIR LOSS)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:VANN
Suffix:
Gender:F
Credentials:CERTIFIED HAIR LOSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 W OREM DR APT 532
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77047-4751
Mailing Address - Country:US
Mailing Address - Phone:281-468-7380
Mailing Address - Fax:
Practice Address - Street 1:10350 S POST OAK RD # 301
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-3313
Practice Address - Country:US
Practice Address - Phone:281-468-7380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-03
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management