Organization
ESSENTIAL MASSAGE & SPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH MODESTO (ADMINISTRATOR)
(956) 465-4082
Entity
Organization
Contact information
Practice address
524 E LOS EBANOS BLVD, BROWNSVILLE, TX 78520-8433
(956) 465-4082
(956) 465-4821
Mailing address
3402 BRASILIA, BROWNSVILLE, TX 78526-1229
(956) 336-7466
(956) 465-4821
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT130039
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT130039
TDLR
TX
Enumeration date
07/16/2018
Last updated
07/16/2018
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