Provider Demographics
NPI:1245001775
Name:RIOS, JASON LOUIS (MASSAGE THERAPIST)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:LOUIS
Last Name:RIOS
Suffix:
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 LABOR ST APT 1413
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78210-2298
Mailing Address - Country:US
Mailing Address - Phone:210-797-9818
Mailing Address - Fax:
Practice Address - Street 1:111 LABOR ST APT 1413
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78210-2298
Practice Address - Country:US
Practice Address - Phone:210-797-9818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1153553133N00000X
AZ1153552171400000X
TXMT109639225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No171400000XOther Service ProvidersHealth & Wellness Coach