1073789046 NPI number — MR. RICHARD JARED VERRETT MASSAGE THERAPIST

Table of content: MR. RICHARD JARED VERRETT MASSAGE THERAPIST (NPI 1073789046)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073789046 NPI number — MR. RICHARD JARED VERRETT MASSAGE THERAPIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VERRETT
Provider First Name:
RICHARD
Provider Middle Name:
JARED
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MASSAGE THERAPIST
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
VERRETT
Provider Other First Name:
RICHARD
Provider Other Middle Name:
JARED
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
NATUROPATH
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1073789046
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2601 N TEXAS BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESLACO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78596-4039
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-447-2444
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2601 N TEXAS BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESLACO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78596-4039
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-447-2444
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/30/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  MT 011057 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com