Organization
TAYLOR LANE PERMANENT MAKEUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERONICA RODRIGUEZ (ASSISTANT)
(609) 828-9288
Entity
Organization
Contact information
Practice address
520 W COLORADO ST, LA GRANGE, TX 78945-2504
(979) 966-8653
Mailing address
520 W COLORADO ST, LA GRANGE, TX 78945-2504
(979) 966-8653
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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