Individual
HEIDI KATHERINE IRATCABAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6484 LONTOS DR, DALLAS, TX 75214-6317
(214) 356-4157
Mailing address
6484 LONTOS DR, DALLAS, TX 75214-6317
(214) 356-4157
Taxonomy
Speciality
Code
Description
License number
State
374K00000X
Religious Nonmedical Practitioner
Primary
L511-2848
TX
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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