Provider Demographics
NPI:1649544495
Name:TSOURMAS, EMILY FRANCINE (LMT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:FRANCINE
Last Name:TSOURMAS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-5059
Mailing Address - Country:US
Mailing Address - Phone:512-657-4504
Mailing Address - Fax:
Practice Address - Street 1:1619 W 6TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-5059
Practice Address - Country:US
Practice Address - Phone:512-657-4504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-25
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17815225700000X
TX116710225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist