Provider Demographics
NPI:1053484154
Name:JAGNEAUX, MARCUSELLA STEVENSON (DC)
Entity Type:Individual
Prefix:DR
First Name:MARCUSELLA
Middle Name:STEVENSON
Last Name:JAGNEAUX
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2855 EASTEX FWY
Mailing Address - Street 2:SUITE E
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-3065
Mailing Address - Country:US
Mailing Address - Phone:409-899-2300
Mailing Address - Fax:409-898-2273
Practice Address - Street 1:2855 EASTEX FWY
Practice Address - Street 2:SUITE E
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-3065
Practice Address - Country:US
Practice Address - Phone:409-899-2300
Practice Address - Fax:409-898-2273
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5226111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor