Provider Demographics
NPI:1275219149
Name:CERVANTES, JASMINE
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:CERVANTES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 CHERRY STREET
Mailing Address - Street 2:APARTMENT 121
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77840
Mailing Address - Country:US
Mailing Address - Phone:915-319-7535
Mailing Address - Fax:
Practice Address - Street 1:503 CHERRY STREET
Practice Address - Street 2:APARTMENT 121
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77840
Practice Address - Country:US
Practice Address - Phone:915-319-7535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program