MEDICARE: DOMINICK TREVAIL AUSTIN

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	148274	TX

General Provider Information

NPI Number	:	1255297131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOMINICK TREVAIL AUSTIN

Provider Business Mailing Address
First Line	:	5016 REDWATER DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76018-2014
Country	:	US
Telephone Number	:	214-429-6038
Fax Number	:

Provider Business Practice Location Address
First Line	:	3921 W GREEN OAKS BLVD STE A
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76016-2791
Country	:	US
Telephone Number	:	817-451-7575
Fax Number	:

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

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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