Provider Demographics
NPI:1790875060
Name:MILESKI, JASON VERN (PT)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:VERN
Last Name:MILESKI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10714 ACACIA FOREST TRL
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-5927
Mailing Address - Country:US
Mailing Address - Phone:281-464-2776
Mailing Address - Fax:
Practice Address - Street 1:10909 EAST FWY # I-10
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77029-1911
Practice Address - Country:US
Practice Address - Phone:713-973-7943
Practice Address - Fax:713-973-7947
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1146420225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T1619OtherBCBS PROVIDER NUMBER