Active NPI
Edward Michael Sandoval, LMT
- Massage Therapist
- Eagle Pass, TX
National Provider Identifier
1639849979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT135526
- Practice address
- 1835 S. Veterans Blvd
Suite 4
Eagle Pass, TX 78852 - Phone
- (830) 319-8816
- NPI assigned
- Sep 17, 2021
- Sex
- Male
- 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 | MT135526 | TX | Primary |
Addresses
Primary practice location
1835 S. Veterans Blvd
Suite 4
Eagle Pass, TX 78852
Mailing address
2709 Stone Hedge
Eagle Pass, TX 78852-3239
Phone (830) 319-8816
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 |
|---|---|---|---|
| MT135526 | TX | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673308800000",
"number": "1639849979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2709 STONE HEDGE",
"city": "EAGLE PASS",
"state": "TX",
"postal_code": "788523239",
"telephone_number": "830-319-8816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1835 S. VETERANS BLVD",
"address_2": "SUITE 4",
"city": "EAGLE PASS",
"state": "TX",
"postal_code": "78852",
"telephone_number": "830-319-8816"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDOVAL",
"first_name": "EDWARD",
"middle_name": "MICHAEL",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-09-17",
"last_updated": "2023-01-10",
"certification_date": "2023-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TX",
"license": "MT135526",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eagle Pass, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.