Provider Demographics
NPI:1316472962
Name:SCARSELLA, JENNIFER KAZUKO (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KAZUKO
Last Name:SCARSELLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3322 COLORADO BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6889
Mailing Address - Country:US
Mailing Address - Phone:940-387-7588
Mailing Address - Fax:940-566-0881
Practice Address - Street 1:3322 COLORADO BLVD STE 101
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6889
Practice Address - Country:US
Practice Address - Phone:940-387-7588
Practice Address - Fax:940-566-0881
Is Sole Proprietor?:No
Enumeration Date:2017-04-20
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXV30982086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery