Provider Demographics
NPI:1740142504
Name:POSITIVE ENERGY THERAPEUTIC MASSAGE
Entity type:Organization
Organization Name:POSITIVE ENERGY THERAPEUTIC MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:337-212-8237
Mailing Address - Street 1:17301 STUEBNER AIRLINE RD STE 10
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-4628
Mailing Address - Country:US
Mailing Address - Phone:346-270-3508
Mailing Address - Fax:
Practice Address - Street 1:17301 STUEBNER AIRLINE RD STE 10
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-4628
Practice Address - Country:US
Practice Address - Phone:346-270-3508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-01
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty