Provider Demographics
NPI:1659077303
Name:PASTRANO-MANSELL HOLDINGS
Entity Type:Organization
Organization Name:PASTRANO-MANSELL HOLDINGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MANSELL
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:832-260-1853
Mailing Address - Street 1:4119 MEDICAL DR APT D307
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-5982
Mailing Address - Country:US
Mailing Address - Phone:832-260-1853
Mailing Address - Fax:
Practice Address - Street 1:4119 MEDICAL DR APT D307
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5982
Practice Address - Country:US
Practice Address - Phone:832-260-1853
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-03
Last Update Date:2023-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty