Active NPI
Wanda Nerene Holder, LICENSE MASSAGE THER
- Massage Therapist
- Corsicana, TX
National Provider Identifier
1003144916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT010527
- Practice address
- 322 W 7TH Ave
Suite C
Corsicana, TX 75110-6402 - Phone
- (903) 872-2756
- NPI assigned
- Dec 4, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT010527 | TX | Primary |
Addresses
Primary practice location
322 W 7TH Ave
Suite C
Corsicana, TX 75110-6402
Mailing address
2005 W Collin St
Corsicana, TX 75110-4242
Phone (903) 874-1703
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT010527 | TX | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305590400000",
"number": "1003144916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2005 W COLLIN ST",
"city": "CORSICANA",
"state": "TX",
"postal_code": "751104242",
"telephone_number": "903-874-1703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "322 W 7TH AVE",
"address_2": "SUITE C",
"city": "CORSICANA",
"state": "TX",
"postal_code": "751106402",
"telephone_number": "903-872-2756"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLDER",
"first_name": "WANDA",
"middle_name": "NERENE",
"credential": "LICENSE MASSAGE THER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-12-04",
"last_updated": "2011-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TX",
"license": "MT010527",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corsicana, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.