MEDICARE: STEPHEN T BISON 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	MT141374	TX

General Provider Information

NPI Number	:	1942195730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN T BISON LMT

Provider Business Mailing Address
First Line	:	11429 VOLTERRA WAY APT 14207
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76244-1545
Country	:	US
Telephone Number	:	214-808-8616
Fax Number	:

Provider Business Practice Location Address
First Line	:	3401 GOLDEN TRIANGLE BLVD STE 111
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76177-7168
Country	:	US
Telephone Number	:	214-808-8616
Fax Number	:

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

Provider Enumeration Date	:	06/11/2025
Last Update Date	:	06/11/2025

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Directions to “ STEPHEN T BISON LMT” Practice Location

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