Active NPI
Ila Procell, LMT
- Massage Therapist
- Moody, TX
National Provider Identifier
1821597964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT031858
- Practice address
- 407 8TH St
Moody, TX 76557-3849 - Phone
- (832) 689-3513
- NPI assigned
- Feb 5, 2018
- Last updated
- Jun 16, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT031858 | TX | Primary |
Addresses
Primary practice location
407 8TH St
Moody, TX 76557-3849
Mailing address
PO Box 367
Moody, TX 76557-0367
Phone (832) 689-3513
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
| License | State | Type | Specialty |
|---|---|---|---|
| MT031858 | TX | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1821597964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 367",
"city": "MOODY",
"state": "TX",
"postal_code": "765570367",
"telephone_number": "832-689-3513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "407 8TH ST",
"city": "MOODY",
"state": "TX",
"postal_code": "765573849",
"telephone_number": "832-689-3513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROCELL",
"first_name": "ILA",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-05",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TX",
"license": "MT031858",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moody, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.