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Organization
DIVINE BEAUTY BAR, LLC
Active
Organization
DIVINE BEAUTY BAR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEZAREE' LUSK HAIR LOSS SPECIALIST (OWNER)
(469) 499-6200
Entity
Organization
Contact information
Practice address
4201 CYPRESS CREEK PKWY STE 322, HOUSTON, TX 77068-3414
(469) 499-6200
(469) 519-5839
Mailing address
4201 CYPRESS CREEK PKWY STE 322, HOUSTON, TX 77068-3414
(469) 499-6200
(469) 519-5839
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
1449535
TX
251E00000X
Home Health Agency
—
NULL
251G00000X
Community Based Hospice Care Agency
—
NULL
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
335E00000X
Prosthetic/Orthotic Supplier
—
NULL
343900000X
Non-emergency Medical Transport (VAN)
—
NULL
Other
Enumeration date
06/13/2018
Last updated
04/30/2025
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