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NPI Code Detail

MEDICARE: MR. JESUS RAMON JASSO JR. LICENSED PROFESSIONA

MEDICARE: MR. JESUS RAMON JASSO JR. LICENSED PROFESSIONA
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
1101YP2500XProfessional Counselor80183TX

General Provider Information

NPI Number : 1902424757
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JESUS RAMON JASSO JR. LICENSED PROFESSIONA
Provider Business Mailing Address
First Line : 2126 NORTHWEST FREEWAY/21216 U.S. 290 WEST
Second Line : SUITE 450
City : CYPRESS
State : TX
Zip : 77429
Country : US
Telephone Number : 832-237-2673
Fax Number : 832-237-2676
Provider Business Practice Location Address
First Line : 2126 NORTHWEST FREEWAY/21216 U.S. 290 WEST
Second Line : SUITE 450
City : CYPRESS
State : TX
Zip : 77429
Country : US
Telephone Number : 832-237-2673
Fax Number : 832-237-2676
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2020
Last Update Date : 07/08/2020

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