MEDICARE: CHERISH DRIVAS LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	101Y00000X	Counselor
2	171W00000X	Contractor
3	225700000X	Massage Therapist	CA
4	225700000X	Massage Therapist	TX
5	374J00000X	Doula	CA
6	374J00000X	Doula	TX

General Provider Information

NPI Number	:	1750122669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERISH DRIVAS LMT

Provider Business Mailing Address
First Line	:	2221 W DALLAS ST APT 366
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019-4747
Country	:	US
Telephone Number	:	713-766-8437
Fax Number	:

Provider Business Practice Location Address
First Line	:	2221 W DALLAS ST APT 366
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019-4747
Country	:	US
Telephone Number	:	713-538-0998
Fax Number	:

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

Provider Enumeration Date	:	06/04/2024
Last Update Date	:	06/04/2024

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Directions to “ CHERISH DRIVAS LMT” Practice Location

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