MEDICARE: TEXAS MEDICAL MASSAGE, PLLC

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

General Provider Information

NPI Number	:	1114887619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS MEDICAL MASSAGE, PLLC

Provider Business Mailing Address
First Line	:	12239 QUEENSTON BLVD STE D
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-5687
Country	:	US
Telephone Number	:	346-200-2565
Fax Number	:

Provider Business Practice Location Address
First Line	:	12239 QUEENSTON BLVD STE D
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-5687
Country	:	US
Telephone Number	:	346-200-2565
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. KIMBERLY ROSE MERRYAMN
Credential	:	LMT
Telephone Number	:	346-200-2565

Provider Enumeration Date	:	11/17/2025
Last Update Date	:	02/25/2026

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Directions to “TEXAS MEDICAL MASSAGE, PLLC ” Practice Location

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