Bravadas of Fairfax LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

BRAVADAS OF FAIRFAX LLC

Doing business as

Bravadas wigs & Extensions

Practice address

11204 Lee Highway
Fairfax, VA 22030

Phone

(703) 352-4247

NPI assigned

Nov 4, 2015

Last updated

Nov 4, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tracy Hobbs

Title

VP of Operations

Phone

(402) 397-2524

Specialties & licenses 1

Addresses

Other names 1

• Bravadas wigs & Extensions Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446595200000",
    "number": "1285007849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11204 LEE HIGHWAY",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22030",
            "telephone_number": "703-352-4247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11204 LEE HIGHWAY",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22030",
            "telephone_number": "703-352-4247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAVADAS OF FAIRFAX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-04",
        "last_updated": "2015-11-04",
        "status": "A",
        "authorized_official_last_name": "HOBBS",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "402-397-2524"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bravadas wigs & Extensions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Esmie G Branner, MSW., PHD.
• Antoine Rashad Brantley
• Queena Singh Brar, O.D.
• Tracy Allison Brauner, OTR/L
• Bravadas Fairfax LLC (Bravadas Wig Design)
• Bravely Minded LLC
• Bravo Homecare LLC
• Emily Stone Bravo, PA-C
• Tiffany Lauren Brazile, MD
• Breakthrough Chiropractic Care, LLC (Chiropractic & Physical Therapy Center)

• Durable Medical Equipment & Medical Supplies in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Durable Medical Equipment & Medical Supplies in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.