MEDICARE: MR. MICHAEL A HATTER II 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	MT116940	TX

General Provider Information

NPI Number	:	1992269831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL A HATTER II LMT

Provider Business Mailing Address
First Line	:	3415 MERCER ST STE F
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-6524
Country	:	US
Telephone Number	:	832-598-7752
Fax Number	:

Provider Business Practice Location Address
First Line	:	3415 MERCER ST STE F
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-6524
Country	:	US
Telephone Number	:	832-598-7752
Fax Number	:

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

Provider Enumeration Date	:	01/24/2019
Last Update Date	:	01/24/2019

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