Provider Demographics
NPI:1710879879
Name:INTERSTELLAR MASSAGE LLC
Entity type:Organization
Organization Name:INTERSTELLAR MASSAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:BAILEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MIER-NAVA
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:832-497-6069
Mailing Address - Street 1:2045 SPACE PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-6305
Mailing Address - Country:US
Mailing Address - Phone:281-549-4594
Mailing Address - Fax:
Practice Address - Street 1:2045 SPACE PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-6305
Practice Address - Country:US
Practice Address - Phone:281-549-4594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty