Provider Demographics
NPI:1366931719
Name:CREATION OF BEAUTY INC.
Entity type:Organization
Organization Name:CREATION OF BEAUTY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUTFI
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:LUTFI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-353-0603
Mailing Address - Street 1:4031 CHENAULT ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76111-6907
Mailing Address - Country:US
Mailing Address - Phone:817-353-0603
Mailing Address - Fax:817-838-3737
Practice Address - Street 1:4031 CHENAULT ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76111-6907
Practice Address - Country:US
Practice Address - Phone:817-353-0603
Practice Address - Fax:817-838-3737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-01
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)