Shoushan Wang, MT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT123464 Issued in TX

Practice address

1000 S New Rd # 130
Waco, TX 76711-1300

Phone

(254) 900-7798

NPI assigned

Sep 11, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Medical Technician

State licenses

Practice roles

Locations

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

• XJS Corporation

  • Massage Therapist
  • Waco, TX
  • NPI 1265219778
  NPD Authorized official

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1700663218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5020 FM 1960 RD W STE 6",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770694519",
            "telephone_number": "254-900-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S NEW RD # 130",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767111300",
            "telephone_number": "254-900-7798"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6001 W Waco Dr Ste 314",
            "address_purpose": "LOCATION",
            "city": "Waco",
            "state": "TX",
            "postal_code": "767106302",
            "country_code": "US",
            "telephone_number": "254-900-7788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "SHOUSHAN",
        "credential": "MT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-11",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT123464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eagan Stuart Walters
• Fred A Walters, MD
• Brian L Walton, MD
• Li Wan
• May Wang, MD
• Rachel Fahlenkamp Warapius, APRN, FNP-C
• Cherri M Ward, NNP-BC
• Elizabeth Ward
• Hayley Ward, MD
• Janis M. Ward, SOCIAL WORKER

• Massage Therapist in Waco, TX
• Providers in Waco, TX by specialty
• Massage Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.