Healthcare Provider Details

I. General information

NPI: 1487408266
Provider Name (Legal Business Name): JOHN ERWIN PASCUAL AUD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2024
Last Update Date: 05/19/2024
Certification Date: 05/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14634 MEMORIAL DR
HOUSTON TX
77079-7517
US

IV. Provider business mailing address

4930 GOSFORD RD APT 120
BAKERSFIELD CA
93313-6103
US

V. Phone/Fax

Practice location:
  • Phone: 281-741-7295
  • Fax:
Mailing address:
  • Phone: 832-888-7693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number3875
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number81720
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: