Provider Demographics
NPI:1053665620
Name:SYLVESTRE, ANASTASIA (NURSING ASSISTANT)
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:
Last Name:SYLVESTRE
Suffix:
Gender:F
Credentials:NURSING ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8519 QUAIL HILLS DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-5366
Mailing Address - Country:US
Mailing Address - Phone:832-738-3242
Mailing Address - Fax:
Practice Address - Street 1:8519 QUAIL HILLS DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-5366
Practice Address - Country:US
Practice Address - Phone:832-738-3242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-05
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA8663653261QM0850X
CA00312557103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst