MEDICARE: LAURA ANDRIA CARRASCO

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	MT144685	TX

General Provider Information

NPI Number	:	1679367809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA ANDRIA CARRASCO

Provider Business Mailing Address
First Line	:	1397 GEORGE DIETER DR STE G
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-7681
Country	:	US
Telephone Number	:	915-500-9939
Fax Number	:

Provider Business Practice Location Address
First Line	:	1397 GEORGE DIETER DR STE G
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-7681
Country	:	US
Telephone Number	:	915-500-9939
Fax Number	:

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

Provider Enumeration Date	:	04/04/2025
Last Update Date	:	04/17/2026

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Directions to “ LAURA ANDRIA CARRASCO ” Practice Location

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