Provider Demographics
NPI:1639985229
Name:DABNEY, CLINT MAJOR (LMT117373)
Entity type:Individual
Prefix:
First Name:CLINT
Middle Name:MAJOR
Last Name:DABNEY
Suffix:
Gender:M
Credentials:LMT117373
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8106 BLOOMING MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77016-2249
Mailing Address - Country:US
Mailing Address - Phone:832-520-6947
Mailing Address - Fax:
Practice Address - Street 1:2827 N MAIN ST
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-5511
Practice Address - Country:US
Practice Address - Phone:832-819-3055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT117373225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist