Individual provider Active NPI

Larita Buckhanas, LMT

  • Massage Therapist
  • Dallas, TX
National Provider Identifier
1659264257
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT029655 Issued in TX
Practice address
11133 Shady TRL # 470
Dallas, TX 75229-4617
Phone
(214) 807-6778
Fax
(888) 830-8403
NPI assigned
Jun 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT029655 TX Primary

Addresses

Primary practice location

11133 Shady TRL # 470
Dallas, TX 75229-4617

Mailing address

2329 Edenborn Ave
Metairie, LA 70001-1815

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

LicenseStateTypeSpecialty
MT029655TXMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Wellness - Central Texas LLC Massage Therapist CurrentSince Jun 8, 2025 Accepting new patients

Locations

2329 Edenborn Ave
Metairie, LA 70001
Phone (504) 571-5355

11133 Shady Trl
#470
Dallas, TX 75229
Phone (214) 807-6778

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1748822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1659264257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2329 EDENBORN AVE",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700011815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11133 SHADY TRL # 470",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752294617",
            "telephone_number": "214-807-6778",
            "fax_number": "888-830-8403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKHANAS",
        "first_name": "LARITA",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-02",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT029655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.

Verify at the official NPI Registry.