Provider Demographics
NPI:1992009781
Name:ARMENTANO, DAVID PETER (LMT, MMP)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:PETER
Last Name:ARMENTANO
Suffix:
Gender:M
Credentials:LMT, MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 CASTLE GARDENS DR APT 290
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-2217
Mailing Address - Country:US
Mailing Address - Phone:469-309-8243
Mailing Address - Fax:
Practice Address - Street 1:1008 WINSCOTT RD STE A
Practice Address - Street 2:
Practice Address - City:BENBROOK
Practice Address - State:TX
Practice Address - Zip Code:76126-2779
Practice Address - Country:US
Practice Address - Phone:469-309-8243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-07
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT111247225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist