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General NPI Number Information
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NPI Number | 1558233486
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Entity Type | Individual
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Provider Name | MELYSSA LIBERTY LMT
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Gender | Female
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Dates
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Enumeration Date | 09/20/2025
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Last Update Date | 09/20/2025
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Provider Practice Location Address
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Address Line | 4303 CALLICOATTE RD
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City | CORPUS CHRISTI
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State | TX
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Zip | 78410-3915
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Country | US
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Telephone | 361-261-5261
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Fax |
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Provider Business Mailing Address
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Address Line | 5326 COUNTY ROAD 73 APT B
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City | ROBSTOWN
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State | TX
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Zip | 78380-5980
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Country | US
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Telephone | 512-699-2777
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Fax |
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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 | MT036442
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License Number State | TX
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