Provider Demographics
NPI:1891801288
Name:PASCHALL, REGINA KAYE (PT)
Entity Type:Individual
Prefix:MS
First Name:REGINA
Middle Name:KAYE
Last Name:PASCHALL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:REGINA
Other - Middle Name:KAYE
Other - Last Name:STAFFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3620 GUMWOOD AVE
Mailing Address - Street 2:#8
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-8000
Mailing Address - Country:US
Mailing Address - Phone:281-685-3752
Mailing Address - Fax:
Practice Address - Street 1:2109 S K CENTER STREET
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503
Practice Address - Country:US
Practice Address - Phone:956-688-5515
Practice Address - Fax:958-618-2439
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1061570225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist