MEDICARE: MRS. JUANITA M ASCENCIO OTR

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	225X00000X	Occupational Therapist	112606	TX

General Provider Information

NPI Number	:	1588839807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JUANITA M ASCENCIO OTR

Provider Business Mailing Address
First Line	:	PO BOX 720157
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-0157
Country	:	US
Telephone Number	:	956-682-6900
Fax Number	:	956-683-7192

Provider Business Practice Location Address
First Line	:	910 E 8TH ST STE 7
Second Line	:
City	:	WESLACO
State	:	TX
Zip	:	78596-4346
Country	:	US
Telephone Number	:	956-447-3565
Fax Number	:	956-447-8944

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

Provider Enumeration Date	:	04/28/2008
Last Update Date	:	04/28/2008

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