Provider Demographics
NPI:1669914131
Name:JASMINOY, JAVIER M
Entity type:Individual
Prefix:
First Name:JAVIER
Middle Name:M
Last Name:JASMINOY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10802 TALLOW BRIAR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77075-1356
Mailing Address - Country:US
Mailing Address - Phone:832-594-0651
Mailing Address - Fax:281-677-4257
Practice Address - Street 1:10802 TALLOW BRIAR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77075-1356
Practice Address - Country:US
Practice Address - Phone:832-594-0651
Practice Address - Fax:281-677-4257
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator