Organization
EGATE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON WONG LMT (LICENSED MASSAGE THERAPIST)
(832) 741-7654
Entity
Organization
Contact information
Practice address
12818 CENTURY DR STE 1102, STAFFORD, TX 77477-4224
(832) 741-7654
Mailing address
12307 MAPLE LEAF LN, STAFFORD, TX 77477-1691
(832) 741-7654
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT119442
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT119442
DEPARTMENT OF STATE HEALTH SERAVICES
TX
Enumeration date
05/08/2015
Last updated
05/08/2015
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