Provider Demographics
NPI:1902158819
Name:JALOCON, JOYCE ANN NINA BACSIBIO (PT, PTRP)
Entity type:Individual
Prefix:MS
First Name:JOYCE ANN NINA
Middle Name:BACSIBIO
Last Name:JALOCON
Suffix:
Gender:F
Credentials:PT, PTRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 SLEEPY HOLLOW DR
Mailing Address - Street 2:APT 216
Mailing Address - City:CLEVELAND
Mailing Address - State:TX
Mailing Address - Zip Code:77327-4349
Mailing Address - Country:US
Mailing Address - Phone:407-924-4867
Mailing Address - Fax:
Practice Address - Street 1:300 E CROCKETT ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TX
Practice Address - Zip Code:77327-4029
Practice Address - Country:US
Practice Address - Phone:281-593-1811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1211326225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist