Clint Colbert IV, MT1168787
Individual provider Active NPI Massage Therapist · Buda, TX
NPI 1235810946 · NPPES record last updated Jul 26, 2023
Key facts
- NPI
- 1235810946
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MT116878 (TX)
- Practice address
- 825 Main St Ste 150
Buda, TX 78610-3410 - Phone
- (210) 929-2839
- NPI assigned
- Jul 26, 2023
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT116878 | TX | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT116878 | TX | Yes |
Addresses
Primary practice location
825 Main St Ste 150
Buda, TX 78610-3410
Mailing address
345 Champion Blvd Apt 318
San Marcos, TX 78666-6782
Phone (210) 535-8567
Other providers in Buda, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.