Active NPI
Tin Trung Phan
- Massage Therapist
- Spring, TX
National Provider Identifier
1952085276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT026763
- Practice address
- 504 Spring Hill Dr Ste 420
Spring, TX 77386-6029 - Phone
- (713) 385-6974
- NPI assigned
- Jun 15, 2023
- Sex
- Male
- Sole proprietor
- No
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 | MT026763 | TX | Primary |
Addresses
Primary practice location
504 Spring Hill Dr Ste 420
Spring, TX 77386-6029
Mailing address
504 Spring Hill Dr Ste 420
Spring, TX 77386-6029
Phone (183) 229-3795
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 |
|---|---|---|---|
| MT026763 | TX | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686787200000",
"number": "1952085276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 SPRING HILL DR STE 420",
"city": "SPRING",
"state": "TX",
"postal_code": "773866029",
"telephone_number": "183-229-3795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "504 SPRING HILL DR STE 420",
"city": "SPRING",
"state": "TX",
"postal_code": "773866029",
"telephone_number": "713-385-6974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "TIN",
"middle_name": "TRUNG",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-15",
"last_updated": "2023-06-15",
"certification_date": "2023-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TX",
"license": "MT026763",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spring, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.