Individual
JESUS VASQUEZ II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2708 BROOKSIDE LN, MCKINNEY, TX 75070-4212
(214) 755-0292
Mailing address
2708 BROOKSIDE LN, MCKINNEY, TX 75070-4212
(214) 755-0292
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2046241
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2046241
PHYSICAL THERAPIST ASSISTANT - REGULAR LICENSE
TX
Enumeration date
12/12/2016
Last updated
12/12/2016
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