Provider Demographics
NPI:1609156876
Name:ESCARENO, JENNIFER LEA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEA
Last Name:ESCARENO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 E RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-5904
Mailing Address - Country:US
Mailing Address - Phone:956-207-2485
Mailing Address - Fax:
Practice Address - Street 1:223 E RIDGE RD
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-5904
Practice Address - Country:US
Practice Address - Phone:956-207-2485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-19
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1212548225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist