Provider Demographics
NPI:1366189813
Name:SCOTT, JASMINE ALYSE
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:ALYSE
Last Name:SCOTT
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 1:6495 BELL POINTE
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-2590
Mailing Address - Country:US
Mailing Address - Phone:409-289-3956
Mailing Address - Fax:
Practice Address - Street 1:7080 CALDER AVE
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-6052
Practice Address - Country:US
Practice Address - Phone:409-861-1123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant