Provider Demographics
NPI:1417729807
Name:SIMPSON, VANESSA CAROLINA (PT, DPT)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:CAROLINA
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:CAROLINA
Other - Last Name:ROMERO-GANDARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:5628 MACRAE ST
Mailing Address - Street 2:
Mailing Address - City:HALTOM CITY
Mailing Address - State:TX
Mailing Address - Zip Code:76148-3918
Mailing Address - Country:US
Mailing Address - Phone:817-899-5077
Mailing Address - Fax:
Practice Address - Street 1:2432 AVONDALE HASLET RD STE 300
Practice Address - Street 2:
Practice Address - City:HASLET
Practice Address - State:TX
Practice Address - Zip Code:76052-3428
Practice Address - Country:US
Practice Address - Phone:817-717-9111
Practice Address - Fax:817-717-8999
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-27
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1278974225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist