Provider Demographics
NPI:1639788276
Name:NAYAR, AJIT (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:AJIT
Middle Name:
Last Name:NAYAR
Suffix:
Gender:M
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 1:4249 LA ADELITA DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79922-2340
Mailing Address - Country:US
Mailing Address - Phone:915-320-0468
Mailing Address - Fax:
Practice Address - Street 1:6633 N MESA ST STE 507
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-4422
Practice Address - Country:US
Practice Address - Phone:915-320-0468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT120363225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist