Provider Demographics
NPI:1427880228
Name:JANSSEN, MICHALA ELAINE (PT)
Entity type:Individual
Prefix:
First Name:MICHALA
Middle Name:ELAINE
Last Name:JANSSEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5210 THOUSAND OAKS DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78233-6974
Mailing Address - Country:US
Mailing Address - Phone:210-733-9050
Mailing Address - Fax:210-733-9069
Practice Address - Street 1:5210 THOUSAND OAKS DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78233-6974
Practice Address - Country:US
Practice Address - Phone:210-733-9050
Practice Address - Fax:210-733-9069
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1395368225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist