MEDICARE: WENDY BROUGH

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MT142254	TX

General Provider Information

NPI Number	:	1295534741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY BROUGH

Provider Business Mailing Address
First Line	:	3003 LAKE ESTATE CT
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-3954
Country	:	US
Telephone Number	:	979-837-6852
Fax Number	:

Provider Business Practice Location Address
First Line	:	5011 HIGHWAY 6 STE 103
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-4799
Country	:	US
Telephone Number	:	713-829-0125
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2025
Last Update Date	:	03/10/2025

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Directions to “ WENDY BROUGH ” Practice Location

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