MEDICARE: THERASSAGE MEDICAL SOLUTION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363LP2300X	Primary Care Nurse Practitioner
2	133NN1002X	Nutrition Education Nutritionist
3	207Q00000X	Family Medicine Physician
4	225700000X	Massage Therapist
5	363LF0000X	Family Nurse Practitioner
6	103T00000X	Psychologist
7	2085B0100X	Body Imaging Physician
8	171100000X	Acupuncturist
9	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1255955761
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERASSAGE MEDICAL SOLUTION

Provider Business Mailing Address
First Line	:	1808 SNAKE RIVER RD STE D
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-7746
Country	:	US
Telephone Number	:	346-546-9653
Fax Number	:	832-626-3627

Provider Business Practice Location Address
First Line	:	1808 SNAKE RIVER RD STE D
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-7746
Country	:	US
Telephone Number	:	346-546-9653
Fax Number	:	832-626-3627

Authorized Official
Title or Position	:	OWNER
Name	:	INGRID BADILLO GONZALEZ
Credential	:	LMT
Telephone Number	:	346-546-9653

Provider Enumeration Date	:	06/01/2020
Last Update Date	:	10/27/2025

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Directions to “THERASSAGE MEDICAL SOLUTION ” Practice Location

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