Organization
LINGERIE LINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA B RAMIREZ (OWNER)
(210) 656-4090
Entity
Organization
Contact information
Practice address
8209 ROUGHRIDER DR, SUITE 102, SAN ANTONIO, TX 78239-2434
(210) 656-4090
(210) 946-5471
Mailing address
PO BOX 18301, SAN ANTONIO, TX 78218-0301
(210) 656-4090
(210) 946-5471
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011042101
—
TX
05
—
011042102
—
TX
01
—
530034
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/22/2005
Last updated
02/23/2023
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