Active NPI
Drue Davis, LMT, MMP
- Massage Therapist
- Wichita Falls, TX
National Provider Identifier
1013465749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT110419
- Practice address
- 2304 9TH St
Wichita Falls, TX 76301-4031 - Phone
- (940) 636-2846
- NPI assigned
- Sep 11, 2016
- Sex
- Male
- 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 | MT110419 | TX | Primary |
Addresses
Primary practice location
2304 9TH St
Wichita Falls, TX 76301-4031
Mailing address
4667 University Ave
Wichita Falls, TX 76308-3353
Phone (940) 636-2846
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 |
|---|---|---|---|
| MT110419 | TX | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473552000000",
"number": "1013465749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4667 UNIVERSITY AVE",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763083353",
"telephone_number": "940-636-2846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2304 9TH ST",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763014031",
"telephone_number": "940-636-2846"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "DRUE",
"credential": "LMT, MMP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-09-11",
"last_updated": "2016-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TX",
"license": "MT110419",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita Falls, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.