Active NPI
Leticia Reyes, LICMASSAGE THERAPIST
- Massage Therapist
- Plano, TX
National Provider Identifier
1043711633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT102405
- Practice address
- 4666 McDermott Rd Suite 100
Plano, TX 75024 - Phone
- (972) 668-6868
- NPI assigned
- Feb 28, 2018
- Sex
- Female
- Sole proprietor
- No
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 | MT102405 | TX | Primary |
Addresses
Primary practice location
4666 McDermott Rd Suite 100
Plano, TX 75024
Mailing address
PO Box 118381
Carrollton, TX 75011-8381
Phone (469) 381-4181
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MT102405 | Other | TX | LICENSE MASSAGE THERAPY |
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 |
|---|---|---|---|
| MT102405 | TX | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sol Medical Massage Inc | Massage Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Massage Therapist
- Plano, TX
- NPI 1720587538
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519776000000",
"number": "1043711633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 118381",
"city": "CARROLLTON",
"state": "TX",
"postal_code": "750118381",
"telephone_number": "469-381-4181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4666 MCDERMOTT RD SUITE 100",
"city": "PLANO",
"state": "TX",
"postal_code": "75024",
"telephone_number": "972-668-6868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES",
"first_name": "LETICIA",
"credential": "LICMASSAGE THERAPIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-28",
"last_updated": "2018-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TX",
"license": "MT102405",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE MASSAGE THERAPY",
"identifier": "MT102405",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.