Provider Demographics
NPI:1912215930
Name:MASKE, VANESSA THERESA (DC)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:THERESA
Last Name:MASKE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 N GREENVILLE AVE
Mailing Address - Street 2:SUITE 340
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-1202
Mailing Address - Country:US
Mailing Address - Phone:214-842-2923
Mailing Address - Fax:877-466-7919
Practice Address - Street 1:1514 N GREENVILLE AVE
Practice Address - Street 2:SUITE 340
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-1202
Practice Address - Country:US
Practice Address - Phone:214-842-2923
Practice Address - Fax:877-466-7919
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11555111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor