Active NPI
Evolution of Her Beauty LLC
- Physical Therapy Assistant
- Dallas, TX
National Provider Identifier
1356093512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 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
- Evolution Care
National Provider Directory
National Provider DirectoryLocations
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.
-
- Physical Therapy Assistant
- Richardson, TX
- NPI 1336717958
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.