Provider Demographics
NPI:1740384890
Name:CASSELLA, WENDY HOUSTON (PT)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:HOUSTON
Last Name:CASSELLA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2758 N GALLOWAY AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-6380
Mailing Address - Country:US
Mailing Address - Phone:972-681-1155
Mailing Address - Fax:972-681-3575
Practice Address - Street 1:2758 N GALLOWAY AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-6380
Practice Address - Country:US
Practice Address - Phone:972-681-1155
Practice Address - Fax:972-681-3575
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1152840225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist