David Keith Elder, LMT, MTI, MMP
Individual provider Active NPI Massage Therapist · Justin, TX
NPI 1285180992 · NPPES record last updated Sep 1, 2016
Key facts
- NPI
- 1285180992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MT117873 (TX)
- Practice address
- 8520 Longhorn Dr.
Justin, TX 76247 - Phone
- (260) 602-6708
- NPI assigned
- Sep 1, 2016
- 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 |
|---|---|---|---|
| MT117873 | TX | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT117873 | TX | Yes |
Addresses
Primary practice location
8520 Longhorn Dr.
Justin, TX 76247
Mailing address
8520 Longhorn Dr.
Justin, TX 76247
Phone (260) 602-6708
Other providers in Justin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2016. 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.