Individual
MRS. HEIDI MCCAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6080 SOUTHWEST BLVD, BENBROOK, TX 76109-3912
(817) 731-9331
(817) 731-9331
Mailing address
6080 SOUTHWEST BLVD, BENBROOK, TX 76109-3912
(817) 731-9331
(817) 731-9331
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2149963
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149963
TEXAS PTA LICENSE
TX
Enumeration date
09/04/2019
Last updated
02/25/2021
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