Provider Demographics
NPI:1972772150
Name:TORREZ, JESUS MAYA (LMT)
Entity Type:Individual
Prefix:
First Name:JESUS
Middle Name:MAYA
Last Name:TORREZ
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 1:11807 CARVEL LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-2820
Mailing Address - Country:US
Mailing Address - Phone:832-212-7270
Mailing Address - Fax:713-333-5024
Practice Address - Street 1:11807 CARVEL LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-2820
Practice Address - Country:US
Practice Address - Phone:832-212-7270
Practice Address - Fax:713-333-5024
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT035421225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist