Provider Demographics
NPI:1699104950
Name:MASCHAL, KRISTI (PT)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:MASCHAL
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 1:2310 W INTERSTATE 20
Mailing Address - Street 2:STE: 204
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-1677
Mailing Address - Country:US
Mailing Address - Phone:817-466-7276
Mailing Address - Fax:817-466-7286
Practice Address - Street 1:2310 W INTERSTATE 20
Practice Address - Street 2:STE: 204
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-1677
Practice Address - Country:US
Practice Address - Phone:817-466-7276
Practice Address - Fax:817-466-7286
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1116390208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation