Samuel Perez Jr.
Individual provider Active NPI Massage Therapist · Von Ormy, TX
NPI 1447921804 · NPPES record last updated Sep 24, 2021
Key facts
- NPI
- 1447921804
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 135607 (TX)
- Practice address
- 13874 Benton City Rd
Von Ormy, TX 78073-3432 - Phone
- (210) 464-0223
- NPI assigned
- Sep 24, 2021
- 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 |
|---|---|---|---|
| 135607 | TX | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 135607 | TX | Yes |
Addresses
Primary practice location
13874 Benton City Rd
Von Ormy, TX 78073-3432
Mailing address
13874 Benton City Rd
Von Ormy, TX 78073-3432
Phone (210) 464-0223
Other providers in Von Ormy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2021. 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.