Provider Demographics
NPI:1538859194
Name:SBC VENTURES LLC
Entity type:Organization
Organization Name:SBC VENTURES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:214-606-3177
Mailing Address - Street 1:1601 E LAMAR BLVD STE 209
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-4464
Mailing Address - Country:US
Mailing Address - Phone:817-766-6030
Mailing Address - Fax:817-766-5942
Practice Address - Street 1:1601 E LAMAR BLVD STE 209
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-4464
Practice Address - Country:US
Practice Address - Phone:817-766-6030
Practice Address - Fax:817-766-5942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier