Provider Demographics
NPI:1659102754
Name:OSUNERO-LANUZA, MARK F (LMT, MMP, CNMT, CES)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:F
Last Name:OSUNERO-LANUZA
Suffix:
Gender:M
Credentials:LMT, MMP, CNMT, CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:954 HIGHLAND HILLS DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75036-8858
Mailing Address - Country:US
Mailing Address - Phone:609-432-8434
Mailing Address - Fax:
Practice Address - Street 1:954 HIGHLAND HILLS DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75036-8858
Practice Address - Country:US
Practice Address - Phone:609-432-8434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT141732225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist