Individual
MRS. HEATHER RENAE URESTI-BACAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4206 RETAMA CIR, VICTORIA, TX 77901-2765
(361) 582-0611
(361) 582-4978
Mailing address
4206 RETAMA CIR, VICTORIA, TX 77901-2765
(361) 582-0611
(361) 582-4978
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2062240
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164704201
—
TX
Enumeration date
05/16/2008
Last updated
07/15/2009
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