Provider Demographics
NPI:1720506587
Name:BENTLEY, RAINA (LMT)
Entity Type:Individual
Prefix:
First Name:RAINA
Middle Name:
Last Name:BENTLEY
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 1:5301 CAMDEN LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1149
Mailing Address - Country:US
Mailing Address - Phone:713-385-3963
Mailing Address - Fax:
Practice Address - Street 1:16626 SEA LARK RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77062-5819
Practice Address - Country:US
Practice Address - Phone:281-488-0111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-31
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT126517225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist