Provider Demographics
NPI:1265906184
Name:MASKOV, YANA NICOLE
Entity type:Individual
Prefix:MS
First Name:YANA
Middle Name:NICOLE
Last Name:MASKOV
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4316 KINGSBURY DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3246
Mailing Address - Country:US
Mailing Address - Phone:214-235-3613
Mailing Address - Fax:
Practice Address - Street 1:2409 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78712-1112
Practice Address - Country:US
Practice Address - Phone:512-471-1737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program