Tyler Massage, LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

TYLER MASSAGE, LLC

Practice address

704 S Bois D Arc Ave
Tyler, TX 75701-1503

Phone

(903) 520-8611

NPI assigned

Jan 31, 2019

Organization subpart

No

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

Authorized official

Name

Suzanna Moody

Title

Owner

Phone

(903) 520-8611

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548892800000",
    "number": "1821552159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 S BOIS D ARC AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011503",
            "telephone_number": "903-520-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 S BOIS D ARC AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011503",
            "telephone_number": "903-520-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYLER MASSAGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-31",
        "last_updated": "2019-01-31",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "SUZANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-520-8611"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Tyler, TX
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• Massage Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; 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.