Healthcare Provider Details

I. General information

NPI: 1598086860
Provider Name (Legal Business Name): TERESA LEE LMT/HWC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2010
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 BLANCO RD STE 120
SAN ANTONIO TX
78216-4361
US

IV. Provider business mailing address

9327 ANISTON BLF STE 120
CONVERSE TX
78109-0029
US

V. Phone/Fax

Practice location:
  • Phone: 866-977-5668
  • Fax:
Mailing address:
  • Phone: 866-977-5668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT037318
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-3624516
License Number StateAL
# 4
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT037318CE2275
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: