NPIMap

Organization Active NPI

Peacock Heavenly Massage

  • Massage Therapist
  • Port Arthur, TX
National Provider Identifier
1003295312
Registry record updated May 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT034536 Issued in TX
Legal business name
PEACOCK HEAVENLY MASSAGE
Practice address
3800 Hwy 365
Regional Square
Port Arthur, TX 77642
Phone
(409) 724-7882
NPI assigned
May 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Lucy Mae Peacock, LMT
Title
Lis. Massage Therapist
Phone
(409) 724-7882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X MT034536 TX Primary

Addresses

Primary practice location

3800 Hwy 365
Regional Square
Port Arthur, TX 77642

Mailing address

3800 Hwy 365, Suite 159
Port Arthur, TX 77642
Phone (409) 724-7882

National Provider Directory

National Provider Directory

Locations

3800 Highway 365
Port Arthur, TX 77642
Phone (409) 724-7882

3800 Highway 365
Ste 159
Port Arthur, TX 77642

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432080000000",
    "number": "1003295312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 HWY 365, SUITE 159",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "77642",
            "telephone_number": "409-724-7882",
            "fax_number": "409-853-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 HWY 365",
            "address_2": "REGIONAL SQUARE",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "77642",
            "telephone_number": "409-724-7882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACOCK HEAVENLY MASSAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-20",
        "last_updated": "2015-05-20",
        "status": "A",
        "authorized_official_last_name": "PEACOCK",
        "authorized_official_first_name": "LUCY",
        "authorized_official_middle_name": "MAE",
        "authorized_official_title_or_position": "LIS. MASSAGE THERAPIST",
        "authorized_official_telephone_number": "409-724-7882",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT034536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Arthur, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.