Provider Demographics
NPI:1700046026
Name:PASTEKA, KATHRYN E (MT)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:E
Last Name:PASTEKA
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6011 BAKER RD
Mailing Address - Street 2:
Mailing Address - City:NEEDVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77461-8753
Mailing Address - Country:US
Mailing Address - Phone:979-531-9598
Mailing Address - Fax:
Practice Address - Street 1:9102 EMMA ST
Practice Address - Street 2:SUITE B
Practice Address - City:NEEDVILLE
Practice Address - State:TX
Practice Address - Zip Code:77461-8403
Practice Address - Country:US
Practice Address - Phone:979-531-9598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT023622172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist