Organization
LADY LIKE LINGERIE, LLC
Active
Other names
Lady Like Mastectomy Boutique
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIA E CORTINAS CFM (MANAGING MEMBER)
(210) 655-1300
Entity
Organization
Contact information
Practice address
7419 CALLAGHAN RD, SAN ANTONIO, TX 78229-2904
(210) 655-1300
(210) 615-1301
Mailing address
7419 CALLAGHAN RD, SAN ANTONIO, TX 78229-2904
(210) 655-1300
(210) 615-1301
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1583215601
—
TX
05
—
183215602
—
TX
01
—
532420
BLUE CROSS BLUE SHIELD
TX
01
—
87726
SECURE HORIZONS DIRECT
TX
Enumeration date
06/18/2006
Last updated
04/23/2015
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