Individual
MS. IDA MISSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1217 WESTWOOD DR APT 2205, ROSENBERG, TX 77471-2246
(832) 221-8436
Mailing address
1217 WESTWOOD DR APT 2205, ROSENBERG, TX 77471-2246
(832) 221-8436
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT123502
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
87-3304423
MASSAGE THERAPY
TX
05
—
87-3304423
—
TX
Enumeration date
11/08/2021
Last updated
11/08/2021
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