Provider Demographics
NPI:1144889627
Name:BELLA AESTHETICS PLLC
Entity type:Organization
Organization Name:BELLA AESTHETICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEATRICE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-784-0009
Mailing Address - Street 1:5140 CATHEDRAL LN
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76310-1490
Mailing Address - Country:US
Mailing Address - Phone:617-784-0009
Mailing Address - Fax:
Practice Address - Street 1:300 LOOP 11
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76306-3705
Practice Address - Country:US
Practice Address - Phone:940-723-8420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility