Incognito Salon & Spa, LLC

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

Legal business name

INCOGNITO SALON & SPA, LLC

Practice address

2601 Prospect St Ste a
Houston, TX 77004-7737

Phone

(877) 277-4796

NPI assigned

Aug 11, 2022

Organization subpart

Yes

Parent organization

INCOGNITO SALON & SPA, LLCAs reported in NPPES

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

Authorized official

Name

La Tasha Krauth

Title

Director

Phone

(346) 473-5945

Specialties & licenses 1

Addresses

Other names 1

• Third Ward Wellness Clinic / Incognito Spa Clinic Doing business as

Part of

Incognito Salon Spa LLC

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dedra Johnson

  • Family Nurse Practitioner
  • Richmond, TX
  • NPI 1225621154
  NPD (past)

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

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711065600000",
    "number": "1316675838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 ALMEDA RD STE 305",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770047447",
            "telephone_number": "346-473-5945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 PROSPECT ST STE A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770047737",
            "telephone_number": "877-277-4796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INCOGNITO SALON & SPA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INCOGNITO SALON & SPA, LLC",
        "enumeration_date": "2022-08-11",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A",
        "authorized_official_last_name": "KRAUTH",
        "authorized_official_first_name": "LA TASHA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "346-473-5945"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Third Ward Wellness Clinic / Incognito Spa Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Third Ward Wellness Clinic / Incognito Spa Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Incite Health, LLC
• Inclusive Clinics PLLC
• Inclusive Diagnostics, Inc
• Inclusive Healthcare Group, LLC
• Inclusive Wellness & Rehabilitation PLLC
• Incognito Spa Clinic LLC
• Frank Liborio Incrapera, D.D.S.
• Roi Marvin Indefenso, APRN
• Independen Provider
• Independence Care of Texas LLC

• Public Health & General Preventive Medicine Physician in Houston, TX
• Providers in Houston, TX by specialty
• Public Health & General Preventive Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; 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.