Provider Demographics
NPI:1730458985
Name:PROFESSIONAL TOUCH MASSAGE THERAPY
Entity Type:Organization
Organization Name:PROFESSIONAL TOUCH MASSAGE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LIC. MEDICAL MASSAGE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:TANECIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:LMMP
Authorized Official - Phone:832-212-3840
Mailing Address - Street 1:1029 HWY 6 N
Mailing Address - Street 2:SUITE 650-148
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-1043
Mailing Address - Country:US
Mailing Address - Phone:832-212-3840
Mailing Address - Fax:
Practice Address - Street 1:19811 HOPPERS CREEK DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-6631
Practice Address - Country:US
Practice Address - Phone:832-212-3840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-16
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT1114232083P0901X, 225400000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty