Individual
MR. JOHN MARTIN OLDMIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT, BCTMB
Contact information
Practice address
1919 NORTH LOOP W STE 445, HOUSTON, TX 77008-1363
(832) 703-8787
Mailing address
1717 W 34TH ST UNIT 600, HOUSTON, TX 77018-6264
(512) 636-5953
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT132768
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000268
NCBTMB
—
01
—
MT132768
TDLR
TX
Enumeration date
04/23/2020
Last updated
08/16/2020
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