Jasselle Bagang, PT
Individual provider Active NPI Physical Therapy Assistant · Benbrook, TX
NPI 1821392804 · NPPES record last updated Jan 5, 2011
Key facts
- NPI
- 1821392804
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 006745 (NY)
- Practice address
- 5909 Beverly Dr E
2126
Benbrook, TX 76132-5808 - Phone
- (817) 903-1920
- NPI assigned
- Jan 5, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006745 | NY | MD | Podiatrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 006745 | NY | Yes |
Addresses
Primary practice location
5909 Beverly Dr E
2126
Benbrook, TX 76132-5808
Mailing address
5909 Beverly Dr E
2126
Benbrook, TX 76132-5808
Phone (817) 903-1920
Other providers in Benbrook, TX
- Debra Atkisson
- Renee Aviles
- B.E.S.T. of Benbrook, LLC
- Madison Lane Backman
- Chongsuh Bae
- Ian Bailey
- Katherine Baker
- Ballard Family Dentistry in Benbrook
- David Theodore Bancroft
- Henry Barber
All providers in Benbrook, TX · Physical Therapy Assistant in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.