Organization
HI FASHION BOUTIQUE
Active
Organization
HI FASHION BOUTIQUE
Active
Other names
Hi Fashion Wigs Boutique
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIA DEL SOCCORRO WILSON OPERATOR, LICENSED (CEO/PRESIDENT/OWNER)
(210) 732-7070
Entity
Organization
Contact information
Practice address
4522 FREDERICKSBURG RD, A35, SAN ANTONIO, TX 78201-6521
(210) 732-7070
Mailing address
4522 FREDERICKSBURG RD, A35, SAN ANTONIO, TX 78201-6521
(210) 732-7070
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
691-021
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
691-021
TEXAS COSMETOLOGY
TX
Enumeration date
08/13/2006
Last updated
03/20/2011
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