MEDICARE: MELISSA ORSAL JASEK PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	1161320	TX

General Provider Information

NPI Number	:	1376857698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA ORSAL JASEK PT

Provider Business Mailing Address
First Line	:	12509 RUSH CREEK LN
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78732-1991
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5000 BEE CAVES RD STE 204
Second Line	:
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-5254
Country	:	US
Telephone Number	:	512-329-6617
Fax Number	:	512-329-6772

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2010
Last Update Date	:	07/28/2010

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