Provider Demographics
NPI:1851907869
Name:MEDRANO, FRANCISCO JAVIER (LMT)
Entity Type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:JAVIER
Last Name:MEDRANO
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1027
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TX
Mailing Address - Zip Code:77328-1027
Mailing Address - Country:US
Mailing Address - Phone:469-463-2661
Mailing Address - Fax:
Practice Address - Street 1:12675 HIGHWAY 105
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TX
Practice Address - Zip Code:77327-8025
Practice Address - Country:US
Practice Address - Phone:469-463-2661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT109259225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist