Individual
MR. JASON LUSENGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4308 CARMEL MOUNTAIN DR, MCKINNEY, TX 75070-7925
(972) 672-6612
Mailing address
4308 CARMEL MOUNTAIN DR, MCKINNEY, TX 75070-7925
(972) 672-6612
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
372500000X
Chore Provider
—
—
Other
Enumeration date
05/16/2017
Last updated
07/21/2022
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