Heather Weaver, LMT
Individual provider Active NPI Massage Therapist · Keene, TX
NPI 1760748511 · NPPES record last updated Apr 5, 2012
Key facts
- NPI
- 1760748511
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MT113514 (TX)
- Practice address
- 314 S Old Betsy Rd
Keene, TX 76059-2022 - Phone
- (817) 645-0771
- NPI assigned
- Apr 5, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT113514 | TX | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT113514 | TX | Yes |
Addresses
Primary practice location
314 S Old Betsy Rd
Keene, TX 76059-2022
Mailing address
314 S Old Betsy Rd
Keene, TX 76059-2022
Phone (817) 645-0771
Other providers in Keene, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.