MEDICARE: STANTON DEAN

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	107496	TX

General Provider Information

NPI Number	:	1346671526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STANTON DEAN

Provider Business Mailing Address
First Line	:	16502 LAURELFIELD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77059-6524
Country	:	US
Telephone Number	:	832-367-9554
Fax Number	:

Provider Business Practice Location Address
First Line	:	16502 LAURELFIELD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77059-6524
Country	:	US
Telephone Number	:	832-367-9554
Fax Number	:

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

Provider Enumeration Date	:	12/12/2013
Last Update Date	:	12/12/2013

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Directions to “ STANTON DEAN ” Practice Location

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