Provider Demographics
NPI:1376046573
Name:JASSO, MARIA MERCEDES (LVN)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:MERCEDES
Last Name:JASSO
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7020 DOVE TAIL DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2011
Mailing Address - Country:US
Mailing Address - Phone:210-473-6880
Mailing Address - Fax:
Practice Address - Street 1:7020 DOVE TAIL DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-2011
Practice Address - Country:US
Practice Address - Phone:210-473-6880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX323067164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse