MEDICARE: STEPHANIE BUSS LICENSED MASSAGE

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	MT148018	TX

General Provider Information

NPI Number	:	1821799800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE BUSS LICENSED MASSAGE

Provider Business Mailing Address
First Line	:	3223 AUBURN AVE
Second Line	:
City	:	BIG SPRING
State	:	TX
Zip	:	79720-3501
Country	:	US
Telephone Number	:	580-374-2748
Fax Number	:

Provider Business Practice Location Address
First Line	:	702 JOHNSON ST
Second Line	:
City	:	BIG SPRING
State	:	TX
Zip	:	79720-2820
Country	:	US
Telephone Number	:	580-967-0742
Fax Number	:

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

Provider Enumeration Date	:	03/15/2023
Last Update Date	:	05/28/2026

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