Provider Demographics
NPI:1033786074
Name:BARNES, JAYLA M (LMT)
Entity Type:Individual
Prefix:
First Name:JAYLA
Middle Name:M
Last Name:BARNES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19401 STATE HIGHWAY 249 APT 1031
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-3051
Mailing Address - Country:US
Mailing Address - Phone:832-253-2135
Mailing Address - Fax:
Practice Address - Street 1:19401 STATE HIGHWAY 249 APT 1031
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-3051
Practice Address - Country:US
Practice Address - Phone:832-253-2135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT120819225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist