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General NPI Number Information
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NPI Number | 1356204150
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Entity Type | Individual
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Provider Name | ROAUL MARTINIQUE GANDY LMT
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Gender | Male
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 5454 NEWCASTLE ST APT 1904
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City | HOUSTON
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State | TX
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Zip | 77081-2267
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Country | US
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Telephone | 979-730-9882
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Fax | 713-960-1122
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Provider Business Mailing Address
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Address Line | 5454 NEWCASTLE ST APT 1904
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City | HOUSTON
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State | TX
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Zip | 77081-2267
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Country | US
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Telephone | 979-730-9882
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Fax | 713-960-1122
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT134189
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License Number State | TX
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