Provider Demographics
NPI:1073130605
Name:VESPA, PAIGE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:VESPA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17211 FOREST RIDGE PT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-7808
Mailing Address - Country:US
Mailing Address - Phone:713-966-9695
Mailing Address - Fax:
Practice Address - Street 1:21720 KINGSLAND BLVD STE 304
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2551
Practice Address - Country:US
Practice Address - Phone:281-579-5708
Practice Address - Fax:281-579-5701
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1160270225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist