Individual
KEVIN ALBERTO IRAHETA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 SAINT LOUIS AVE, FORT WORTH, TX 76104-3366
(817) 821-5020
Mailing address
305 NE LOOP 280, BUSINESS TOWER 1, SUITE 200, HURST, TX 76053
(817) 292-8787
(817) 789-6849
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
40245
TX
Other
Enumeration date
06/29/2017
Last updated
06/29/2017
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