Provider Demographics
NPI:1063028280
Name:BURTON, INEZ (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:INEZ
Middle Name:
Last Name:BURTON
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 COUNTY ROAD 94 APT 10105
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-2973
Mailing Address - Country:US
Mailing Address - Phone:832-398-3388
Mailing Address - Fax:
Practice Address - Street 1:1701 FAIRWAY DR STE 3B
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-4678
Practice Address - Country:US
Practice Address - Phone:281-533-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT131745225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist