Organization
MASEP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELENA GACITUA (PRESIDENT)
(713) 490-1077
Entity
Organization
Contact information
Practice address
1919 NORTH LOOP W, STE 400, HOUSTON, TX 77008-1364
(713) 490-1077
(713) 691-2330
Mailing address
PO BOX 924150, HOUSTON, TX 77292-4150
(713) 490-1077
(713) 691-2330
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
639250000
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10014080
AMERIGROUP
TX
05
—
159633001
—
TX
01
—
34JC
BLUE CROSS SHIELD
TX
01
—
6400049
EVERCARE
TX
Enumeration date
08/30/2006
Last updated
09/01/2011
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