Provider Demographics
NPI:1700768322
Name:BORREGALES THIELEN, VICTORIA ALEJANDRA
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:ALEJANDRA
Last Name:BORREGALES THIELEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2277 WINROCK BLVD APT 222
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-4083
Mailing Address - Country:US
Mailing Address - Phone:713-438-3305
Mailing Address - Fax:
Practice Address - Street 1:7118 BERTNER AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4904
Practice Address - Country:US
Practice Address - Phone:713-940-1808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT142649225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist