Provider Demographics
NPI:1396155610
Name:HASSEL, REBECCA SUTORIUS (PT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:SUTORIUS
Last Name:HASSEL
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 1:20243 CHELSEA CANYON CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-8714
Mailing Address - Country:US
Mailing Address - Phone:713-538-6193
Mailing Address - Fax:
Practice Address - Street 1:17758 KATY FWY
Practice Address - Street 2:SUITE 3
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094-1335
Practice Address - Country:US
Practice Address - Phone:281-599-3039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1234871225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist