Provider Demographics
NPI:1205727435
Name:BEWIGGED HAIR CLINIC LLC
Entity type:Organization
Organization Name:BEWIGGED HAIR CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:DOLLIS
Authorized Official - Last Name:DARBY
Authorized Official - Suffix:
Authorized Official - Credentials:COSMETOLOGIST
Authorized Official - Phone:504-383-5366
Mailing Address - Street 1:245 JEFFER DR
Mailing Address - Street 2:
Mailing Address - City:WESTWEGO
Mailing Address - State:LA
Mailing Address - Zip Code:70094-2100
Mailing Address - Country:US
Mailing Address - Phone:504-662-8022
Mailing Address - Fax:504-576-0036
Practice Address - Street 1:3005 JEFFERSON HWY STE A
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:LA
Practice Address - Zip Code:70121-2600
Practice Address - Country:US
Practice Address - Phone:504-383-5366
Practice Address - Fax:504-576-0036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-15
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty