MEDICARE: LASANDRA GENINE BUTLER LMT

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	MT107831	TX

General Provider Information

NPI Number	:	1679417935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LASANDRA GENINE BUTLER LMT

Provider Business Mailing Address
First Line	:	5564 HUNTERS BEND LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75249-2302
Country	:	US
Telephone Number	:	214-732-1192
Fax Number	:

Provider Business Practice Location Address
First Line	:	7700 W NORTHWEST HWY STE 271
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75225-2288
Country	:	US
Telephone Number	:	214-732-1192
Fax Number	:

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

Provider Enumeration Date	:	04/16/2026
Last Update Date	:	04/16/2026

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Directions to “ LASANDRA GENINE BUTLER LMT” Practice Location

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