Individual
DR. JUSTIN ROBERT MASCITELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4502 MEDICAL DR FL 2, SAN ANTONIO, TX 78229
(210) 358-8555
(210) 358-8498
Mailing address
7703 FLOYD CURL DR # MC7977, SAN ANTONIO, TX 78229-3901
(210) 358-8555
(210) 358-8576
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
53433
AZ
207T00000X
Neurological Surgery Physician
Primary
R7270
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
252267
—
AZ
05
—
386066001
—
TX
01
—
386066002
CSHCN
TX
Enumeration date
03/24/2010
Last updated
08/23/2018
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