# INCOGNITO SALON & SPA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** INCOGNITO SALON & SPA, LLC
- **Other names:** Third Ward Wellness Clinic / Incognito Spa Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1316675838
- **Legal business name:** INCOGNITO SALON & SPA, LLC
- **Authorized official:** LA TASHA KRAUTH (DIRECTOR)
- **Authorized official phone:** (346) 473-5945

## Contact information

- **Practice address:** 2601 PROSPECT ST STE A, HOUSTON, TX 77004-7737
- **Practice address phone:** (877) 277-4796
- **Mailing address:** 5445 ALMEDA RD STE 305, HOUSTON, TX 77004-7447
- **Mailing address phone:** (346) 473-5945

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | NULL | Yes |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/11/2022
- **Last updated:** 03/22/2024