Provider Demographics
NPI:1336901446
Name:PIMPANIT, SAOWALAK J (LMT)
Entity Type:Individual
Prefix:
First Name:SAOWALAK
Middle Name:J
Last Name:PIMPANIT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 COBIA DR APT 1216
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-1687
Mailing Address - Country:US
Mailing Address - Phone:281-889-1798
Mailing Address - Fax:
Practice Address - Street 1:1618 S MASON RD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-4563
Practice Address - Country:US
Practice Address - Phone:281-889-1798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT135107225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty