Provider Demographics
NPI:1265264469
Name:GOLDEN LOTUS MASSAGE LLC
Entity type:Organization
Organization Name:GOLDEN LOTUS MASSAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HAIFANG
Authorized Official - Middle Name:
Authorized Official - Last Name:XIANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-280-8877
Mailing Address - Street 1:1397 GEORGE DIETER DR STE G
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-7681
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1397 GEORGE DIETER DR STE G
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-7681
Practice Address - Country:US
Practice Address - Phone:915-500-9939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty