Provider Demographics
NPI:1760208961
Name:URESTI, BILLY
Entity type:Individual
Prefix:
First Name:BILLY
Middle Name:
Last Name:URESTI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12785 BELLAIRE ST
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-2902
Mailing Address - Country:US
Mailing Address - Phone:720-635-2287
Mailing Address - Fax:
Practice Address - Street 1:12785 BELLAIRE ST
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-2902
Practice Address - Country:US
Practice Address - Phone:720-635-2287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO951231275171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter