Provider Demographics
NPI:1780387548
Name:CHAPMAN, REDONDA SUE (LMT)
Entity type:Individual
Prefix:
First Name:REDONDA
Middle Name:SUE
Last Name:CHAPMAN
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 1:1822 SNAKE RIVER RD STE E
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-7749
Mailing Address - Country:US
Mailing Address - Phone:281-789-8970
Mailing Address - Fax:
Practice Address - Street 1:1822 SNAKE RIVER RD STE E
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-7749
Practice Address - Country:US
Practice Address - Phone:281-789-8970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT041056225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist