Organization Active NPI

Evolution of Her Beauty LLC

  • Physical Therapy Assistant
  • Dallas, TX
National Provider Identifier
1356093512
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Legal business name
EVOLUTION OF HER BEAUTY LLC
Practice address
4230 Lyndon B Johnson Fwy Ste 413
Dallas, TX 75244-5805
Phone
(469) 708-3954
NPI assigned
Jan 19, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Authorized official

Name
Miss Frances Fennell
Title
Ceo
Phone
(469) 583-1969

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 225200000X Primary

Addresses

Primary practice location

4230 Lyndon B Johnson Fwy Ste 413
Dallas, TX 75244-5805

Mailing address

4109 Kite LN
Mansfield, TX 76063-3498

Other names 2

  • EVOLUTION MEDICAL Doing business as
  • Evolution Care Doing business as

National Provider Directory

National Provider Directory

Locations

4230 Lyndon B Johnson Fwy
Ste 413
Dallas, TX 75244
Phone (469) 583-1969

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645574400000",
    "number": "1356093512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4109 KITE LN",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 LYNDON B JOHNSON FWY STE 413",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752445805",
            "telephone_number": "469-708-3954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION OF HER BEAUTY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A",
        "authorized_official_last_name": "FENNELL",
        "authorized_official_first_name": "FRANCES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "469-583-1969",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EVOLUTION MEDICAL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Evolution Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; 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.