Provider Demographics
NPI:1548635592
Name:DEVORE, STEPHANIE (PTA)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:DEVORE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:TESS
Other - Middle Name:
Other - Last Name:DEVORE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PTA
Mailing Address - Street 1:9220 KIRBY DR
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2533
Mailing Address - Country:US
Mailing Address - Phone:713-383-9700
Mailing Address - Fax:713-383-9795
Practice Address - Street 1:9220 KIRBY DR
Practice Address - Street 2:SUITE 1000
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2533
Practice Address - Country:US
Practice Address - Phone:713-383-9700
Practice Address - Fax:713-383-9795
Is Sole Proprietor?:No
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20437502251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics