Provider Demographics
NPI:1538589056
Name:VESSALI, RHONDA (PTA)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:VESSALI
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 NE LOOP 280; BUSINESS TOWER 1
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76053
Mailing Address - Country:US
Mailing Address - Phone:817-292-8787
Mailing Address - Fax:817-789-6849
Practice Address - Street 1:12941 NORTH FWY
Practice Address - Street 2:SUITE 401
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-1240
Practice Address - Country:US
Practice Address - Phone:832-253-1188
Practice Address - Fax:832-253-1181
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX2017224225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant