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General NPI Number Information
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NPI Number | 1255798294
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Entity Type | Organization
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Legal Business Name | CAROL A ASELAGE
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Dates
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Enumeration Date | 01/21/2016
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Last Update Date | 01/21/2016
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Provider Practice Location Address
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Address Line | 1001 LOUISIANA AVE 304
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City | CORPUS CHRISTI
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State | TX
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Zip | 78404-2833
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Country | US
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Telephone | 361-854-2355
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Fax | 361-854-5521
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Provider Business Mailing Address
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Address Line | 1001 LOUISIANA AVE 304
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City | CORPUS CHRISTI
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State | TX
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Zip | 78404-2833
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Country | US
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Telephone | 361-854-2355
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Fax | 361-854-5521
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Authorized Official
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Title or Position | OWNER
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Name | CAROL ANN ASELAGE
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Credential | CO
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Telephone | 361-854-2355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 203
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License Number State | TX
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