Provider Demographics
NPI:1790320950
Name:URESTI, GRECIA (LVN)
Entity Type:Individual
Prefix:
First Name:GRECIA
Middle Name:
Last Name:URESTI
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 BAUMAN RD
Mailing Address - Street 2:
Mailing Address - City:SOCORRO
Mailing Address - State:TX
Mailing Address - Zip Code:79927
Mailing Address - Country:US
Mailing Address - Phone:325-227-7366
Mailing Address - Fax:
Practice Address - Street 1:201 BAUMAN RD
Practice Address - Street 2:
Practice Address - City:SOCORRO
Practice Address - State:TX
Practice Address - Zip Code:79927-3607
Practice Address - Country:US
Practice Address - Phone:325-227-7366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX349343164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse