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General NPI Number Information
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NPI Number | 1922821321
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Entity Type | Organization
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Legal Business Name | MOLDING MASSAGE BY DORA
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 5540 SARATOGA BLVD
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City | CORPUS CHRISTI
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State | TX
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Zip | 78413-2953
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Country | US
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Telephone | 361-281-3749
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Fax | 361-333-1542
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Provider Business Mailing Address
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Address Line | 5540 SARATOGA BLVD STE 102
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City | CORPUS CHRISTI
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State | TX
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Zip | 78413-2953
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Country | US
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Telephone | 361-281-3749
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Fax | 361-333-1542
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Authorized Official
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Title or Position | OWNER
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Name | DORA SILVIA TASCON
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Credential | MASSAGE THERAPIST
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Telephone | 361-779-7086
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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 |
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License Number State |
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