Provider Demographics
NPI:1922877737
Name:PETRO, HEIDI (PT)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:
Last Name:PETRO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:
Other - Last Name:PARISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16515 STRONG BOX
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-4410
Mailing Address - Country:US
Mailing Address - Phone:518-526-5388
Mailing Address - Fax:
Practice Address - Street 1:16515 STRONG BOX
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-4410
Practice Address - Country:US
Practice Address - Phone:518-526-5388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist