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General NPI Number Information
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NPI Number | 1497910764
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Entity Type | Organization
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Legal Business Name | HERBAL MASSAGE INC
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Dates
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Enumeration Date | 07/25/2008
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Last Update Date | 07/25/2008
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Provider Practice Location Address
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Address Line | 7139 BALLAIRE BLVD
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City | HOUSTON
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State | TX
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Zip | 77074-3505
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Country | US
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Telephone | 713-779-7139
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Fax |
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Provider Business Mailing Address
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Address Line | 7139 BALLAIRE BLVD
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City | HOUSTON
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State | TX
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Zip | 77074-3505
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Country | US
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Telephone | 713-779-7139
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Fax | 713-541-6658
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOSEPH MARTIN
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Credential |
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Telephone | 713-779-7139
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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 | ME0578
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License Number State | TX
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