LISA TATOM (NPI# 1376999169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376999169 |
| Entity Type | Individual |
| Full Name | LISA TATOM |
| Credential | LMT |
| Practice Address |
319 W 50th St Odessa TX 79764-4115 |
| Practice Telephone | 4326382653 |
| Practice Fax Number | 4326149650 |
| Mailing Telephone | 4326382653 |
| Mailing Fax Number | 4326149650 |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2016-05-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MT122817 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
319 W 50TH ST |
| City | ODESSA |
| State | TX |
| Zip Code | 79764-4115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710466610 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 3050 W University Blvd, Odessa, TX 79764 | 2018-08-10 |
| 1962897405 | H-e-b, Lp | Clinical Medical Laboratory | 2501 W. University Blvd, Odessa, TX 79764 | 2015-04-01 |
| 1184022758 | Md Moinul Islam | Physician Assistant | 6030 W. University, Odessa, TX 79764 | 2014-12-15 |
| 1962618637 | D&s Residential Services | Intermediate Care Facility, Mentally Retarded | 10036 West Westland Drive, Odessa, TX 79764 | 2007-05-16 |
| 1992119838 | Gary Chase Jackson | Optometrist | 6030 W University Blvd, Odessa, TX 79764 | 2014-06-18 |
| 1609128594 | Amanda Lynn Paradeaux | Nurse Practitioner | 3001 W University Blvd, Odessa, TX 79764 | 2012-10-03 |
| 1760619498 | Cindy A Smith | Speech-Language Pathologist | 8712 Claymoor Dr, Odessa, TX 79764-1252 | 2009-06-21 |
| 1003316084 | Maranda Pina Garza | Licensed Vocational Nurse | 24 Bookins Ct, Odessa, TX 79764-1401 | 2018-02-16 |
| 1255378717 | United Supermarkets LLC | Durable Medical Equipment & Medical Supplies | 2751 N County Rd W, Odessa, TX 79764-1665 | 2006-06-01 |
| 1578112454 | Shaikat Banerjee | Pharmacist | 2751 N County Rd W, Odessa, TX 79764-1665 | 2019-09-04 |
| Find all providers in zip 79764 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407225774 | Neri Campos-gardea | Massage Therapist | 3952 E 42d, Odessa, TX 79762 | 2015-09-17 |
| 1780019869 | Jan Lee Bivins | Massage Therapist | 322 N Texas Ave Ste 2, Odessa, TX 79761-5184 | 2013-09-09 |
| 1730465428 | Therese A Archer | Massage Therapist | 712 N. Texas Ave, Odessa, TX 79761 | 2011-10-26 |
| 1578798450 | Patricia Rodriguez | Massage Therapist | 3641 N. Dixie Blvd, Odessa, TX 79762 | 2009-05-21 |
| 1689809642 | Mirna Hestand | Massage Therapist | 1428 E 8th St, Odessa, TX 79761-4803 | 2009-05-20 |
| 1598917999 | Concetta Vittoria Dipiazza | Massage Therapist | 13923 Chandron Dr, Odessa, FL 33556-4327 | 2008-10-16 |
| 1750549937 | Brittany Leann Bowen | Massage Therapist | 1301 Wedgewood Ave, Odessa, TX 79761-3437 | 2008-05-24 |
| 1447815550 | Leslie Molinar | Massage Therapist | 3952 E 42nd St, Odessa, TX 79762-5932 | 2019-05-03 |
| 1427471648 | Stacey Diane Redfern | Massage Therapist | 3952 E 42nd St, Suite Aa, Odessa, TX 79762-5932 | 2014-01-23 |
| 1831511641 | Beatrice Valenzuela | Massage Therapist | 3952 E 42nd St, Odessa, TX 79762-5932 | 2014-01-13 |
| Find all providers in ODESSA | ||||
Please comment or provide details below to improve the information on LISA TATOM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.