MEDICARE: ERMA M SULLIVAN

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	MT138113	TX

General Provider Information

NPI Number	:	1851248736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERMA M SULLIVAN

Provider Business Mailing Address
First Line	:	4921 FLIPPER DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78238-5408
Country	:	US
Telephone Number	:	726-237-6740
Fax Number	:

Provider Business Practice Location Address
First Line	:	4921 FLIPPER DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78238-5408
Country	:	US
Telephone Number	:	726-237-6740
Fax Number	:

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

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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