MISS MISTI LYNNE POULOS (NPI# 1508097858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508097858 |
| Entity Type | Individual |
| Full Name | MISS MISTI LYNNE POULOS |
| Credential | LMT |
| Practice Address |
4534 Stanley Ave #361 Fort Worth TX 76115 |
| Practice Telephone | 2146324707 |
| Mailing Telephone | 2146324707 |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2009-08-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MT101862 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
4534 STANLEY AVE #361 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811400047 | Christine Vera Varela | Nurse Practitioner | Clinicas Mi Doctor, 4200 S Freeway Ste 106, Fort Worth, TX 76115 | 2017-11-09 |
| 1376081752 | Cheryl D. Mitchell | Nurse Practitioner | 11803 S. Freeway, Ste. 311, Fort Worth, TX 76115 | 2017-02-06 |
| 1609015312 | Sirisha Bheemaneni | Internal Medicine | 11801 S Frwy, Fort Worth, TX 76115 | 2009-02-19 |
| 1639378292 | Jeffrey J. Raymond | Physician Assistant | 544 West Seminary Dr, Fort Worth, TX 76115 | 2007-07-13 |
| 1336367952 | Luis Sierra-nieves | Physician Assistant | 544 West Seminary Drive, Fort Worth, TX 76115 | 2007-04-20 |
| 1396861209 | Remedios R Cabansag | Obstetrics & Gynecology | 11803 So Freewax, Suite 254, Fort Worth, TX 76115 | 2007-03-22 |
| 1073602611 | Courage Rehab Clinic | Clinic/Center | 1670 North Hampton Road, Suite 110, Desoto, TX 76115 | 2006-10-12 |
| 1548369200 | Vijay Khanna | Podiatrist | 4759 B South Freeway, Ft Worth, TX 76115 | 2006-09-21 |
| 1225045164 | Allan M Wallace | Optometrist | 11803 South Frwy, Suite 114, Fort Worth, TX 76115 | 2006-08-02 |
| 1588684583 | John Lawrence Moses | Pediatrics | 11803 South Freeway #203, Fort Worth, TX 76115 | 2006-07-20 |
| Find all providers in zip 76115 | ||||
| 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 |
|---|---|---|---|---|
| 1730788787 | Johnny Khamphouseng | Massage Therapist | 11100 Monica Ct, Fort Worth, TX 76244-7434 | 2020-10-21 |
| 1427655265 | Joline R Carraway | Massage Therapist | 645 Cross Ridge Cir N, Fort Worth, TX 76120-2435 | 2020-10-05 |
| 1023625720 | Joseph Peter Maslowski | Massage Therapist | 6704 Fall Meadow Dr, Fort Worth, TX 76132-3082 | 2020-09-26 |
| 1962017517 | Arelly Vanessa Orta-gonzales | Massage Therapist | 5501 Jacksboro Hwy Ste 402, Fort Worth, TX 76114-1600 | 2020-09-10 |
| 1699389361 | Mistyanne Green | Massage Therapist | 1606 N Sylvania Ave, Fort Worth, TX 76111-2733 | 2020-09-01 |
| 1316550353 | Cyndi E Jochum | Massage Therapist | 8713 Granite Path, Fort Worth, TX 76244-6987 | 2020-08-28 |
| 1902417173 | Shelby Leigh Butcher | Massage Therapist | 6740 Black Wing Dr, Fort Worth, TX 76137-2356 | 2020-08-12 |
| 1932724325 | Olivia Vaughn | Massage Therapist | 701 E Bluff St Apt 2111, Fort Worth, TX 76102-2351 | 2020-06-10 |
| 1386274207 | Amanda Leigh Phillips | Massage Therapist | 1925 Golden Heights Rd Ste 108, Fort Worth, TX 76177-7074 | 2020-01-20 |
| 1205486867 | Ariel Amber-lynn Carmack | Massage Therapist | 6040 Camp Bowie Blvd Ste 29, Fort Worth, TX 76116-5602 | 2019-09-16 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76115 |
Please comment or provide details below to improve the information on MISS MISTI LYNNE POULOS.
| 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.