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General NPI Number Information
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NPI Number | 1689039786
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Entity Type | Organization
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Legal Business Name | RIAL MASSAGE
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Dates
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Enumeration Date | 12/16/2015
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Last Update Date | 12/16/2015
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Provider Practice Location Address
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Address Line | 10111 GRANT RD
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City | HOUSTON
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State | TX
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Zip | 77070-4534
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Country | US
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Telephone | 832-744-6656
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Fax |
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Provider Business Mailing Address
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Address Line | 10211 APPLERIDGE DR
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City | HOUSTON
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State | TX
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Zip | 77070-4706
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Country | US
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Telephone | 832-744-6656
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Fax |
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Authorized Official
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Title or Position | LICENSE MASSAGE THERAPIST
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Name | LILIANA AHUALLI
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Credential | LMT. PE
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Telephone | 832-744-6656
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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 | 104671
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License Number State | TX
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