MEDICARE: MAXWELL TEAGUE KOCH 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	MTI148106	TX

General Provider Information

NPI Number	:	1790623056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAXWELL TEAGUE KOCH LMT

Provider Business Mailing Address
First Line	:	11160 JOLLYVILLE RD APT 704
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-5573
Country	:	US
Telephone Number	:	972-302-7145
Fax Number	:

Provider Business Practice Location Address
First Line	:	11160 JOLLYVILLE RD APT 704
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-5573
Country	:	US
Telephone Number	:	972-302-7145
Fax Number	:

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

Provider Enumeration Date	:	03/24/2026
Last Update Date	:	03/24/2026

Similar Medicare Providers

1285605196 — WILLIAM BLAISEDALE BETTS MD
Practice Location Address:

3218 PARK HILLS DR
AUSTIN, TX
78746-5573

Practice Phone: 512-327-5354
Practice Fax: 512-327-5466

1194305581 — SANA PSYCHIATRY, PLLC
Practice Location Address:

4425 S MOPAC EXPY , STE 502
AUSTIN, TX
78735-5573

Practice Phone: 844-472-6267
Practice Fax: 210-899-1221

1548319916 — DR. LESLIE LUDWIG CORTES M.D.
Practice Location Address:

12401 RESEARCH BLVD STE 220
AUSTIN, TX
78759-2314

Practice Phone: 512-349-5573
Practice Fax:

1851638613 — BEJAINE BAYOT PHARMD
Practice Location Address:

3550 S GENERAL BRUCE DR
TEMPLE, TX
76504-5138

Practice Phone: 254-295-1057
Practice Fax:

1275937039 — NOVA CHIROPRACTIC SERVICES PC
Practice Location Address:

6860 AUSTIN ST , SUITE 404
FOREST HILLS, NY
11375-4245

Practice Phone: 914-419-3190
Practice Fax: 800-520-5573

1104361831 — AUSTIN BUBB
Practice Location Address:

820 WHIPORWILL DR
PORT ORANGE, FL
32127-5969

Practice Phone: 386-589-5573
Practice Fax:

Directions to “ MAXWELL TEAGUE KOCH LMT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.