Provider Demographics
NPI:1881427375
Name:LOCKS OF LOVE CANCER HAIR CARE AND MASTECTOMY
Entity type:Organization
Organization Name:LOCKS OF LOVE CANCER HAIR CARE AND MASTECTOMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAUN
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-562-2186
Mailing Address - Street 1:209 SPERRY LN
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-4057
Mailing Address - Country:US
Mailing Address - Phone:214-562-2186
Mailing Address - Fax:
Practice Address - Street 1:209 SPERRY LN
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154-4057
Practice Address - Country:US
Practice Address - Phone:214-562-2186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No224900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMastectomy FitterGroup - Multi-Specialty