MEDICARE: RICHELLE PRINCE 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	MT120435	TX

General Provider Information

NPI Number	:	1215473814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHELLE PRINCE LMT

Provider Business Mailing Address
First Line	:	8519 BROCK PARK BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77078-3601
Country	:	US
Telephone Number	:	713-851-0934
Fax Number	:

Provider Business Practice Location Address
First Line	:	18321 W LAKE HOUSTON PKWY
Second Line	:	SUITE 310
City	:	HUMBLE
State	:	TX
Zip	:	77346-3587
Country	:	US
Telephone Number	:	832-463-1780
Fax Number	:

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

Provider Enumeration Date	:	01/06/2017
Last Update Date	:	01/06/2017

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Directions to “ RICHELLE PRINCE LMT” Practice Location

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