Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 108921 | TX |
NPI | 1154439222 |
---|---|
Provider Name | Mrs. Jennifer Gayle Vasquez |
First Address | The Woodlands, TX 77380-1410 |
Second Address | The Woodlands, TX 77380-1410 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2006 |
Last Update Date | 13/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8T3022 | BCBS OF TX (01) | TX |