Provider Demographics
NPI:1083465629
Name:MINOR, NATASHA
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:MINOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16027 RONDA DALE DR
Mailing Address - Street 2:
Mailing Address - City:HOCKLEY
Mailing Address - State:TX
Mailing Address - Zip Code:77447-7713
Mailing Address - Country:US
Mailing Address - Phone:920-264-7519
Mailing Address - Fax:
Practice Address - Street 1:16027 RONDA DALE DR
Practice Address - Street 2:
Practice Address - City:HOCKLEY
Practice Address - State:TX
Practice Address - Zip Code:77447-7713
Practice Address - Country:US
Practice Address - Phone:920-264-7519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program