Healthcare Provider Details

I. General information

NPI: 1376000794
Provider Name (Legal Business Name): MEDICAL MASSAGE RX II
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2019
Last Update Date: 12/07/2020
Certification Date: 12/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4235 PRESTON RD STE 300
FRISCO TX
75034-9564
US

IV. Provider business mailing address

2430 FM 407 STE B
HIGHLAND VILLAGE TX
75077-3090
US

V. Phone/Fax

Practice location:
  • Phone: 972-317-2612
  • Fax:
Mailing address:
  • Phone: 940-453-4310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: ANITA K. RAUHAUSER
Title or Position: CFO
Credential:
Phone: 214-729-3911