Active NPI
Vicki S Bryan, MT,MTI
- Massage Therapist
- Lubbock, TX
National Provider Identifier
1497941470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MIO1968
- Practice address
- 1717 Norfolk Ave BLDG B
#1371
Lubbock, TX 79416-6035 - Phone
- (806) 792-2085
- Fax
- (806) 794-9283
- NPI assigned
- Sep 24, 2007
- 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 | MIO1968 | TX | Primary |
Addresses
Primary practice location
1717 Norfolk Ave BLDG B
#1371
Lubbock, TX 79416-6035
Mailing address
PO Box 64549
Lubbock, TX 79464-4549
Phone (806) 438-2125
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
- Credentials
- Medical Technician
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MIO1968 | TX | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190592000000",
"number": "1497941470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 64549",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794644549",
"telephone_number": "806-438-2125",
"fax_number": "806-794-9283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 NORFOLK AVE BLDG B",
"address_2": "#1371",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794166035",
"telephone_number": "806-792-2085",
"fax_number": "806-794-9283"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRYAN",
"first_name": "VICKI",
"middle_name": "S",
"credential": "MT,MTI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-24",
"last_updated": "2007-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TX",
"license": "MIO1968",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.