Active NPI
Imelda Lucia Jean
- Massage Therapist
- El Paso, TX
National Provider Identifier
1477365948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT118238
- Practice address
- 2077 N Zaragoza Rd # A102
El Paso, TX 79938-7900 - Phone
- (915) 274-4125
- NPI assigned
- Jan 22, 2025
- Last updated
- Jan 22, 2025
- 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 | MT118238 | TX | Primary |
Addresses
Primary practice location
2077 N Zaragoza Rd # A102
El Paso, TX 79938-7900
Mailing address
9030 Betel Dr Apt D11
El Paso, TX 79907-2950
Phone (915) 208-1009
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 |
|---|---|---|---|
| MT118238 | TX | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1737504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737504000000",
"number": "1477365948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9030 BETEL DR APT D11",
"city": "EL PASO",
"state": "TX",
"postal_code": "799072950",
"telephone_number": "915-208-1009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2077 N ZARAGOZA RD # A102",
"city": "EL PASO",
"state": "TX",
"postal_code": "799387900",
"telephone_number": "915-274-4125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEAN",
"first_name": "IMELDA",
"middle_name": "LUCIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-01-22",
"last_updated": "2025-01-22",
"certification_date": "2025-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TX",
"license": "MT118238",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Paso, TX
- JB Kids Therapy LLC
- JCKM, LLC Abbe C Fannin Sole MBR
- JCL Construction
- JCS Medical Transportation LLC
- JDMD Clinics, P. a. (El Paso Advanced Pain Institute)
- Jeanette Tan, MD, PA
- Jedi Force Inc (Medic Sabor Medical Supplies)
- Jee Anesthesia PLLC
- Kelsey Alane Jeffers, AGACNP-BC
- Jeffrey H. Annabi, M.D., P.a.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.