Provider Demographics
NPI:1174302640
Name:BILLUPS, RADIANCE SLIGER (LMT)
Entity type:Individual
Prefix:
First Name:RADIANCE
Middle Name:SLIGER
Last Name:BILLUPS
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 1:1040 KENSINGTON CASTLE TRL
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-7571
Mailing Address - Country:US
Mailing Address - Phone:512-825-4430
Mailing Address - Fax:
Practice Address - Street 1:1040 KENSINGTON CASTLE TRL
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-7571
Practice Address - Country:US
Practice Address - Phone:512-825-4430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT139004225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist