Provider Demographics
NPI:1669002101
Name:WALKER, FRANK MARVIN JR (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:MARVIN
Last Name:WALKER
Suffix:JR
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:MR
Other - First Name:FRANK
Other - Middle Name:MARVIN
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5126 N LOOP 1604 E APT 3205
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-5956
Mailing Address - Country:US
Mailing Address - Phone:210-605-4604
Mailing Address - Fax:
Practice Address - Street 1:21320 WATER WOOD DR
Practice Address - Street 2:
Practice Address - City:GARDEN RIDGE
Practice Address - State:TX
Practice Address - Zip Code:78266-2784
Practice Address - Country:US
Practice Address - Phone:210-806-6941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT132234225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist