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NPI Code Detail

MEDICARE: CAROLYN KINGSBERRY MT

MEDICARE:   CAROLYN  KINGSBERRY  MT
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
1225700000XMassage Therapist114863

General Provider Information

NPI Number : 1598385973
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLYN KINGSBERRY MT
Provider Business Mailing Address
First Line : 13111 INGRAM GAP LN
Second Line :
City : HOUSTON
State : TX
Zip : 77048-1126
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2543 CARTWRIGHT RD
Second Line :
City : MISSOURI CITY
State : TX
Zip : 77459-2606
Country : US
Telephone Number : 832-892-5786
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2020
Last Update Date : 04/25/2020

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Directions to “ CAROLYN KINGSBERRY MT” Practice Location

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