Provider Demographics
NPI:1962217364
Name:WE ARE NOTORIOUS INC.
Entity type:Organization
Organization Name:WE ARE NOTORIOUS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ISMAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:ARCHIBLE
Authorized Official - Suffix:
Authorized Official - Credentials:CCSP
Authorized Official - Phone:678-206-6712
Mailing Address - Street 1:5900 BALCONES DR STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4298
Mailing Address - Country:US
Mailing Address - Phone:678-206-6712
Mailing Address - Fax:
Practice Address - Street 1:13304 GALAGA ST # A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77048-4679
Practice Address - Country:US
Practice Address - Phone:678-206-6712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment