Provider Demographics
NPI:1861935272
Name:LUTHER BEAUTY VENTURES
Entity type:Organization
Organization Name:LUTHER BEAUTY VENTURES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-984-5223
Mailing Address - Street 1:3120 HUDSON XING
Mailing Address - Street 2:STE A2
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-6553
Mailing Address - Country:US
Mailing Address - Phone:972-984-5223
Mailing Address - Fax:
Practice Address - Street 1:3120 HUDSON XING
Practice Address - Street 2:STE A2
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-6553
Practice Address - Country:US
Practice Address - Phone:972-984-5223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-02
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service