Provider Demographics
NPI:1639172430
Name:MASCIARELLI, FILIPPO (MD)
Entity Type:Individual
Prefix:DR
First Name:FILIPPO
Middle Name:
Last Name:MASCIARELLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 S LOCUST ST
Mailing Address - Street 2:STE 200
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-6023
Mailing Address - Country:US
Mailing Address - Phone:940-600-7527
Mailing Address - Fax:940-383-1251
Practice Address - Street 1:525 S LOCUST ST
Practice Address - Street 2:STE 200
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-6023
Practice Address - Country:US
Practice Address - Phone:940-600-7527
Practice Address - Fax:940-383-1251
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2013-12-17
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-03-30
Provider Licenses
StateLicense IDTaxonomies
TXJ9753207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122082405Medicaid
TXG25667Medicare UPIN
TX8037K0Medicare PIN
TXTXB164535Medicare PIN