Individual
ANTOINE TYRONE OLIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T; REFLEXOLOGIST
Contact information
Practice address
5539 RICHMOND AVE, HOUSTON, TX 77056-6615
(713) 969-0743
Mailing address
21679 HORSESHOE DR, PORTER, TX 77365-6499
(713) 969-0743
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
—
—
174400000X
Specialist
—
—
225700000X
Massage Therapist
Primary
MT122240
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT122240
LICENSED MASSAGE THERAPIST
TX
Enumeration date
10/15/2015
Last updated
01/28/2020
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