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NPI Code Detail

MEDICARE: EDITH ASSENETH VAESA

MEDICARE: EDITH ASSENETH VAESA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant2043719TX

General Provider Information

NPI Number : 1346725876
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDITH ASSENETH VAESA
Provider Business Mailing Address
First Line : 10311 GLADEWOOD DR
Second Line :
City : HOUSTON
State : TX
Zip : 77041-8827
Country : US
Telephone Number : 713-816-8882
Fax Number :
Provider Business Practice Location Address
First Line : 7215 WINDFERN RD
Second Line :
City : HOUSTON
State : TX
Zip : 77040-2301
Country : US
Telephone Number : 713-466-8933
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2018
Last Update Date : 10/01/2018

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Directions to “ EDITH ASSENETH VAESA ” Practice Location

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