Marie C Vervil, MASSAE THERAPIST

Primary specialty

ReflexologistTaxonomy code 173C00000X

License

MT047765 Issued in TX

Practice address

2125 W Southlake Blvd
Southlake, TX 76092-6758

Phone

(817) 903-4749

NPI assigned

Nov 18, 2013

Last updated

Nov 18, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1384732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384732800000",
    "number": "1720418338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 JOCKEY CLUB LN",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761792359",
            "telephone_number": "817-847-5694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 W SOUTHLAKE BLVD",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926758",
            "telephone_number": "817-903-4749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERVIL",
        "first_name": "MARIE",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "MASSAE THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-18",
        "last_updated": "2013-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173C00000X",
            "taxonomy_group": "",
            "desc": "Reflexologist",
            "state": "TX",
            "license": "MT047765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE THERAPIST",
            "identifier": "80/0566438",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Reflexologist in Southlake, TX
• Providers in Southlake, TX by specialty
• Reflexologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; 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.