Individual
MS. SANDRA YASSKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.O.T.
Contact information
Practice address
302 E 24TH ST, BRYAN, TX 77803-5303
(979) 821-9474
Mailing address
2901 JENNIFER DR, COLLEGE STATION, TX 77845-5755
(979) 696-6661
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
100920
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83012T
—
TX
Enumeration date
08/12/2006
Last updated
07/08/2007
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