Provider Demographics
NPI:1982289856
Name:SUTTON, WESLEY (PT, DPT)
Entity Type:Individual
Prefix:
First Name:WESLEY
Middle Name:
Last Name:SUTTON
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 1:1111 RUSK ST APT 409
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-3429
Mailing Address - Country:US
Mailing Address - Phone:940-781-6514
Mailing Address - Fax:
Practice Address - Street 1:9432 KATY FWY STE 320
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-6370
Practice Address - Country:US
Practice Address - Phone:281-558-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1343377225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist