Provider Demographics
NPI:1649152711
Name:LA XPERIENCE LLC
Entity type:Organization
Organization Name:LA XPERIENCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LARHEA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-939-0133
Mailing Address - Street 1:5775 BLAIRVIEW ST APT 501
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-0512
Mailing Address - Country:US
Mailing Address - Phone:724-939-0133
Mailing Address - Fax:724-939-0133
Practice Address - Street 1:8111 LYNDON B JOHNSON FWY STE 810
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-1386
Practice Address - Country:US
Practice Address - Phone:724-939-0133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies