Provider Demographics
NPI:1336548296
Name:CALABRESE, JULIE MELISSA (PT)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:MELISSA
Last Name:CALABRESE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:MELISSA
Other - Last Name:BEVERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:11116 MARION RD
Mailing Address - Street 2:UNIT 301
Mailing Address - City:SANGER
Mailing Address - State:TX
Mailing Address - Zip Code:76266-3298
Mailing Address - Country:US
Mailing Address - Phone:940-231-9266
Mailing Address - Fax:
Practice Address - Street 1:2318 SAN JACINTO BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-7535
Practice Address - Country:US
Practice Address - Phone:940-380-9111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-17
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1246880225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist