Provider Demographics
NPI:1689473910
Name:HOLDEN, CONSWELLA
Entity type:Individual
Prefix:
First Name:CONSWELLA
Middle Name:
Last Name:HOLDEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 MCCUE RD APT 23
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-4656
Mailing Address - Country:US
Mailing Address - Phone:832-954-3270
Mailing Address - Fax:832-954-3270
Practice Address - Street 1:2320 MCCUE RD APT 23
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-4656
Practice Address - Country:US
Practice Address - Phone:832-954-3270
Practice Address - Fax:832-954-3270
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT144290225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist