Provider Demographics
NPI:1154788685
Name:NECESSARY, MALISSA (LMT, MMP)
Entity type:Individual
Prefix:
First Name:MALISSA
Middle Name:
Last Name:NECESSARY
Suffix:
Gender:F
Credentials:LMT, MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5110 ABERCREEK AVE
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-3305
Mailing Address - Country:US
Mailing Address - Phone:832-567-8818
Mailing Address - Fax:
Practice Address - Street 1:5110 ABERCREEK AVE
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-3305
Practice Address - Country:US
Practice Address - Phone:832-567-8818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-28
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT121224225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1154788685OtherNPI