Healthcare Provider Details

I. General information

NPI: 1902698756
Provider Name (Legal Business Name): ASHLEY ROBERTSON LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16626 SEA LARK RD
HOUSTON TX
77062-5819
US

IV. Provider business mailing address

800 E SOUTH ST APT 705
ALVIN TX
77511-3665
US

V. Phone/Fax

Practice location:
  • Phone: 281-488-0111
  • Fax:
Mailing address:
  • Phone: 713-408-0616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT122686
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: