MEDICARE: JEANETTE CROOM

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	024594	TX

General Provider Information

NPI Number	:	1386535383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANETTE CROOM

Provider Business Mailing Address
First Line	:	3001 DOVE COUNTRY DR APT 1707
Second Line	:
City	:	STAFFORD
State	:	TX
Zip	:	77477-6034
Country	:	US
Telephone Number	:	832-606-0922
Fax Number	:

Provider Business Practice Location Address
First Line	:	16742 SOUTHWEST FWY STE 19
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-2331
Country	:	US
Telephone Number	:	832-606-0922
Fax Number	:

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

Provider Enumeration Date	:	07/09/2025
Last Update Date	:	07/09/2025

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Directions to “ JEANETTE CROOM ” Practice Location

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