Provider Demographics
NPI:1790098515
Name:ISGITT, JENIVIE OVADA (MA)
Entity Type:Individual
Prefix:
First Name:JENIVIE
Middle Name:OVADA
Last Name:ISGITT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 THORNRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-6212
Mailing Address - Country:US
Mailing Address - Phone:936-446-9650
Mailing Address - Fax:
Practice Address - Street 1:1404 THORNRIDGE RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-6212
Practice Address - Country:US
Practice Address - Phone:936-446-9650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist