Provider Demographics
NPI:1043769375
Name:ISRAEL, FE ESPERANZA LAO (PT)
Entity Type:Individual
Prefix:
First Name:FE ESPERANZA
Middle Name:LAO
Last Name:ISRAEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:FE
Other - Middle Name:LAO
Other - Last Name:ISRAEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:25343 BULL RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PORTER
Mailing Address - State:TX
Mailing Address - Zip Code:77365-6505
Mailing Address - Country:US
Mailing Address - Phone:713-992-0138
Mailing Address - Fax:
Practice Address - Street 1:25343 BULL RIDGE DR
Practice Address - Street 2:
Practice Address - City:PORTER
Practice Address - State:TX
Practice Address - Zip Code:77365-6505
Practice Address - Country:US
Practice Address - Phone:713-992-0138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1050540225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist