MEDICARE: JAYLA M BARNES LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MT120819	TX

General Provider Information

NPI Number	:	1033786074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAYLA M BARNES LMT

Provider Business Mailing Address
First Line	:	19401 STATE HIGHWAY 249 APT 1031
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-3051
Country	:	US
Telephone Number	:	832-253-2135
Fax Number	:

Provider Business Practice Location Address
First Line	:	19401 STATE HIGHWAY 249 APT 1031
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-3051
Country	:	US
Telephone Number	:	832-253-2135
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2021
Last Update Date	:	06/08/2021

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