# TEA HOUSE ESTHETICS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841153194
- **Authorized official:** DR. TORI SIMS (DIRECTOR)
- **Authorized official phone:** (470) 538-7129

## Contact information

- **Practice address:** 1042 NORTHSIDE DRIVE NE, M210, ATLANTA, GA 30324
- **Practice address phone:** (470) 538-7129
- **Mailing address:** 1042 NORTHSIDE DRIVE NE, M210, ATLANTA, GA 30324

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | — | NULL | — |
| 207N00000X | Dermatology Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 12/04/2025
- **Last updated:** 12/04/2025