Healthcare Provider Details

I. General information

NPI: 1215836622
Provider Name (Legal Business Name): ANGELICA MARIA MURILLO LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2026
Last Update Date: 11/02/2026
Certification Date: 11/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2102 HOUSTON BLVD
SOUTH HOUSTON TX
77587-5141
US

IV. Provider business mailing address

2102 HOUSTON BLVD
SOUTH HOUSTON TX
77587-5141
US

V. Phone/Fax

Practice location:
  • Phone: 346-279-4642
  • Fax:
Mailing address:
  • Phone: 346-279-4642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT132214
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: