Provider Demographics
NPI:1538936091
Name:VESSEL, LATONYA MARIE
Entity type:Individual
Prefix:
First Name:LATONYA
Middle Name:MARIE
Last Name:VESSEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18519 PARMA CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-2797
Mailing Address - Country:US
Mailing Address - Phone:225-572-9074
Mailing Address - Fax:
Practice Address - Street 1:18519 PARMA CREEK TRL
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-2797
Practice Address - Country:US
Practice Address - Phone:225-572-9074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator