MEDICARE: TRIFECTA THERAPY, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	2255A2300X	Athletic Trainer
2	261QR0400X	Rehabilitation Clinic/Center
3	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1407675382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRIFECTA THERAPY, LLC

Provider Business Mailing Address
First Line	:	25329 BUDDE RD STE 704
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77380-1695
Country	:	US
Telephone Number	:	832-779-1698
Fax Number	:

Provider Business Practice Location Address
First Line	:	25329 BUDDE RD STE 704
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77380-1695
Country	:	US
Telephone Number	:	832-779-1698
Fax Number	:

Authorized Official
Title or Position	:	MASSAGE THERAPIST &ATHLETIC TRAINER
Name	:	DR. ROBIN HUDSON
Credential	:	DAT, LMT, CHES
Telephone Number	:	832-779-1698

Provider Enumeration Date	:	10/07/2024
Last Update Date	:	07/10/2025

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