Healthcare Provider Details

I. General information

NPI: 1972978773
Provider Name (Legal Business Name): GUORUI HUANG LMT, LMI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: WILSON HUANG

II. Dates (important events)

Enumeration Date: 12/04/2015
Last Update Date: 12/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 E 20TH ST STE D
HOUSTON TX
77008
US

IV. Provider business mailing address

740 E 20TH ST STE D
HOUSTON TX
77008
US

V. Phone/Fax

Practice location:
  • Phone: 281-826-6862
  • Fax:
Mailing address:
  • Phone: 281-826-6862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT110447
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: