Provider Demographics
NPI:1689039786
Name:RIAL MASSAGE
Entity Type:Organization
Organization Name:RIAL MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSE MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LILIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:AHUALLI
Authorized Official - Suffix:
Authorized Official - Credentials:LMT PE
Authorized Official - Phone:832-744-6656
Mailing Address - Street 1:10211 APPLERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4706
Mailing Address - Country:US
Mailing Address - Phone:832-744-6656
Mailing Address - Fax:
Practice Address - Street 1:10111 GRANT RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4534
Practice Address - Country:US
Practice Address - Phone:832-744-6656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104671225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty