Active NPI
Tiffany Renee De Los Santos, LMT MMP
- Massage Therapist
- Texarkana, TX
National Provider Identifier
1447560198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT105086
- Practice address
- 4044 Summerhill SQ.
Texarkana, TX 75503 - Phone
- (903) 791-9922
- NPI assigned
- Oct 15, 2010
- Sex
- Female
- 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 | MT105086 | TX | Primary |
Addresses
Primary practice location
4044 Summerhill SQ.
Texarkana, TX 75503
Mailing address
4044 Summerhill SQ.
Texarkana, TX 75503
Phone (903) 791-9922
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 |
|---|---|---|---|
| MT105086 | TX | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287100800000",
"number": "1447560198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4044 SUMMERHILL SQ.",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "75503",
"telephone_number": "903-791-9922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4044 SUMMERHILL SQ.",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "75503",
"telephone_number": "903-791-9922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LOS SANTOS",
"first_name": "TIFFANY",
"middle_name": "RENEE",
"credential": "LMT MMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-15",
"last_updated": "2010-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TX",
"license": "MT105086",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Texarkana, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.