Individual
MISS VANESSA SCIALOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8441 STATE HIGHWAY 47, BRYAN, TX 77807-3207
(979) 776-8896
Mailing address
8441 STATE HIGHWAY 47, BRYAN, TX 77807-3207
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA07972
TX
Other
Enumeration date
07/09/2013
Last updated
07/09/2013
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