Provider Demographics
NPI:1396256608
Name:CESPEDES, JOE IVAN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:JOE
Middle Name:IVAN
Last Name:CESPEDES
Suffix:
Gender:M
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 1:1232 W MILE 14 N
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78599-2018
Mailing Address - Country:US
Mailing Address - Phone:956-246-9272
Mailing Address - Fax:
Practice Address - Street 1:6100 N 10TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3239
Practice Address - Country:US
Practice Address - Phone:956-994-8880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-14
Last Update Date:2017-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1293580225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist