Healthcare Provider Details

I. General information

NPI: 1700777588
Provider Name (Legal Business Name): JOEL BROOKS LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2025
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1524 S INTERSTATE 35 STE 235
AUSTIN TX
78704-2600
US

IV. Provider business mailing address

2329 EDENBORN AVE
METAIRIE LA
70001-1815
US

V. Phone/Fax

Practice location:
  • Phone: 210-866-5558
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: