Individual
MS. JANE M MASCORRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4206 RETAMA CIR, VICTORIA, TX 77901-2765
(361) 582-0611
(361) 582-0555
Mailing address
4206 RETAMA CIR, VICTORIA, TX 77901-2765
(361) 582-0611
(361) 582-0555
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2055651
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164704201
—
TX
Enumeration date
06/27/2006
Last updated
07/14/2009
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